What's new
What's new

Emergency planning for hydraulic injection injury


Mar 12, 2001
New Haven, CT
This topic came up at work today. Hydraulic injection injuries are an incredibly scary thing that requires emergency surgery right away.

The problem is that initially the injuries don't look that serious and often hospitals will send a patient home with minor treatment only to have them return in a few hours requiring amputation of parts affected.

Do any of your companies have plans in place to deal with such a thing if it happens? We work with a lot of large hydraulic machines that we build, many of them use nastier than usual hydraulic fluids such as Skydrol and other solvents. Should any of us have such an injury I don't even know which hospitals in the area would know what they are looking at.

I was thinking at a minimum the company should know which hospitals in the area are capable of understanding the severity of the issue. How does a company go about figuring this out?

Ever try calling a hospital these days and trying to get someone competent to answer?

I am thinking the company should probably also provide training to us employees that if you feel something like a bee sting you need to go to the ER and insist on surgery right away!

Any one know of any good resources that I can recommend to my company to both train us and put an emergency plan in place?

My last employer was such a large aircraft OEM that they actually had their own plant doctor. We all received training on what a hydraulic injection injury was and how to know when to suspect it if it happened to you. Should an injury like this have occurred their plant doctor would take you to the hospital and insist on the correct surgical procedures. Our current place is far too small for such a thing but knowing what hospital to turn to and having a designated driver if not getting an ambulance would probably be a very good idea. Seems like the best time to put a good emergency response plan in place as long before you ever have one.

Here's a few articles to give you a warm and fuzzy feeling about this issue;

Here's a good industry article Here's one from the medical perspective;
Actually,hospitals do get a surprising number of fluid injection injuries from the hardware store pressure cleaners .....not as serious as oil injection,for sure ,
We used to use pilgrim bolts ( hydraulic bolts) to set roll segments into the continuous casters, the power pack was 3000 bar, not a typo btw, one fitter took a squirt to his hand, not good, up the hospital, kept in overnight, he reckoned they flushed the hole, but it went straight through apparently, there wasn’t a written down injection injury procedure for us but the surgery in the steelplant had a doctor, nurses , X-ray etc etc so I’m going to assume they had considered the injury type, it was mostly burns but there’s an awful lot of hydraulic or fluid power in a steelplant, not 3k bar but high enough
I reckon if you got hit by a 3” hydraulic pipe flex failure it would be which morgue to take you to, as Fred dibnah used to say it would get you half a day at the funeral parlour.
Staying away from hydraulics as much as poss is a good plan, burst sleeves were put on ones you had to be around, they work to dissipate the energy and protect us soft flesh bags
30 years ago our company jumped on the bandwagon when high pressure 'washers' came around....the shop was using them to blast motor windings out of the stators. I seem to recall they were operating at tens of thousands of PSI. Anyway, they decided to stop using them after one of the guys got a bit careless and cleanly sliced off the toe portion of his boot, along with a few of his toes.
I would think the best you could do is educate your own work force, post warnings and have a ready to go sheet when someone gets such an injury.
The real problem would be if the injured party does not understand they have such an injury and goes home and ends up at the hospital later
Your insurance company may have resources for this sort of thing. Some do help with safety training and procedures.

It eases the pain a small bit while they bleed you white.
In my employment history I worked in Aerospace on firing rocket engines as well as later on as a safety consultant for a workers compensation company. Both industries were known for hydraulic injuries. In the agricultural/farm areas such injuries were especially common. Workers would from time to time place their hands on leaking tubing on tractor accessories, not realizing that the pressure inside was often 3,000 psi hydraulic. Once a limb became infused with hydraulic fluid, there was often no alternative to surgery, often leading to amputation. We often had safety meetings where the dangers were stressed but workers often forget.
Start with your industrial hygienist or OSHA. If you don't have one, get one. They will need to contact your local hospitals to find out which hospital is best suited for the injury you'd expect. Not a clue who to contact at the hospital, but you start at the bottom...and I'll be honest, sometimes it's easier to just show up, on a non-emergency basis, on a weekday, and ask the triage nurse in the ED who you need to contact. If you can show up with pictures of what the injury might look like (at different time intervals), it will help. And honesty is the best policy.

My experience with hospitals for stuff like this is the bigger the better. If I get bit (dog or cat) at work, insurance wants me to start at the local urgent care. I however make the call as to whether I'm going to the urgent care or the university hospital based upon the vaccination status of the animal. If the animal is not vaccinated for rabies, I know that it's necessary for me to go to the university hospital for a booster, and they are the only ones that keep it on hand. I go with the state health departments flow sheet in hand, expecting that I have to be my own advocate....and I also start out the visit with an apology, as I'm aware that it's not an emergency, but they are the only ones equipped to treat it.

That right there is the key when dealing with modern healthcare. You have to be your own advocate, and be understanding of what is a priority. If your employee goes in with legitimate printed references of what happened, what can happen, and how quickly it progresses, they get taken a lot more seriously than if they go in with greasy overalls complaining about a bee sting while throwing a fit because nobody is listening to them tell a story about their great uncle Harry.
Hey! When it comes to emergency planning for hydraulic injection injuries, it's important to start with your industrial hygienist or reach out to OSHA. If you don't have one, consider getting in touch with a professional who can help. They'll connect with local hospitals to find the best one for the injury you expect.

Contacting the hospital can be easier if you show up on a non-emergency basis, on a weekday, and speak to the triage nurse in the Emergency Department. Bringing pictures of the injury at different intervals can be useful. Remember, larger hospitals often have better resources for such incidents.

In healthcare, it's essential to be your own advocate and understand priorities. If employees come prepared with documentation of the incident and its progression, they'll be taken more seriously. And if you're dealing with a workers' compensation case, consulting a ambulance chaser is always bestest.
Hey !
Mr ambulance chaser.....
I would suggest talking to your Dr. Tell him what you want to do and ask him to recommend the Dr. that is the go to guy on hydraulic injection injuries.
We use several large quantity liquid gases,frost burns, as well as up to 5,500 psi hydraulic systems and high pressure diesel systems. Employee safety training is paramont when dealing with these dangers. High pressure body injection of any liquid/gas require immediate trained medical attention by someone who understands the dangers associated with compressed injection.
Most if not all hospitals by now have search sources for the compressed injection treatment as the general emergency room doctor may have never seen this type of injury, that is to say some of these injected materials need immediate response treatment, certain materials injected can be lethal in short order.
When I wasw 14 I attended a "tractor's driving clinic" to get a cert to reduce liability concerns - for working for others.

I was already long past the mechanics of it (driving skills) but there was films on farm safety, and while I was already 100% up to speed on what a PTO can and will gladly doo to you, they spent a little time showing the effects of this concern on one video. THAT was new to me, and I appreciated that heads up as I wouldn't have ever guessed that. Especially as the OP mentioned, the hydraulic inclusion into the bloodstream, and not just the cutting concerns.

I doo think that people need to be told and maybe even reminded of the hidden danger of the knife effect, as well as the inclussion concerns. This isn't Saline Solution!


Think Snow Eh!