Diphoterine FAQs


Please find below the answers to the most frequently asked questions about Diphoterine. If you have a question that is not covered here or would like to discuss something in further detail, please do not hesitate to call to speak to one of our advisors who will be very happy to help.

Diphoterine® solution is a polyvalent, hypertonic, amphoteric chelating agent for emergency decontamination of corrosive or irritant chemical s[plashes to the skin or eyes. Diphoterine® is a sterile solution provided in dispenser formats to facilitate quick and effective decontamination. When used within the first minute of the splash, using the full contents of the dispenser for the appropriate area, the solution will minimise or prevent a chemical injury and the formation of lesions.

 

Diphoterine® solution contains the Diphoterine® molecule which is an amphoteric chelating molecule that can actively bind chemically opposite componds. In this way the aggressive action of acids, alkalis, oxidising agents, reducing agents chelating agents and solvents can be stopped.

Its hypertonicity to the body also aids in setting up an osmotic gradient which can stop the penetration of chemicals and assist in removing chemicals which have already penetrated into the tissue.

Diphoterine® solution is hypertonic to prevent the penetration of the chemicals into the tissues. A hyperosmolar pressure creates a gentle reverse flow from the inside to the outside of the tissues thus assisting the removal of penetrated chemical and accelerating the decontamination.

 

An amphoteric compound can bind opposing chemical groups - for example acid:base, oxidising agent:reducing agent.

By rinsing with an amphoteric solution such as Diphoterine® we can bind and render harmless the aggressor thus improving the decontamination process, reducing the pain felt by the casualty and returning the skin or eyes to a safe physiological zone more quickly and effectively resulting in a better outcome.

 

Diphoterine® solution is a chelator. It can chelate radionuclides such as strontium, cobalt, cesium or uranium. It can chelate anions such as oxalate, but can't chelate calcium or magnesium.

Diphoterine® solution is polyvalent and is effective against a very wide range of chemicals and chemical groups including acids, bases, oxidising agents, reducing agents, chelating agents and solvents. It is also effective against lachrymators.

Diphoterine® therefore provides a single protocol for decontaminating unknown chemical splashes to the skin and eyes.

 

Diphoterine® solution is non-toxic* and no toxicity has been reported in workplace use on humans. The manufacturer has an active pharmacovigilence program..(*LD50 > 2,000 mg/kg oral/skin in experimental animals)

No mutagenic effect was detected by an Ames test.

Diphoterine® solution and its reaction residues with strong acids and alkalis are not irritating to rabbit eyes. Testing on human volunteers also showed no irritation.  No adverse effects have been reported following the use of Diphoterine® in workplace accidents.   Diphoterine® was not shown to be a skin sensitiser in tests.

In ecotoxicity tests with standard test organisms, Diphoterine® was found to be non-toxic

Diphoterine® solution should be used for emergency first aid decontamination of chemical splashes to skin and eyes of irritant and corrosive chemicals such as acids, alkalis, oxidising agents, reducing agents, chelating agents and solvents.

Diphoterine® solution has limited efficacy on Hydrofluoric Acid and its derivatives. Hexafluorine®solution is specifically designed for this chemical group.

Diphoterine® is not suitable for white phosphorus decontamination.

Diphoterine® solution is most effective in the first minute following the exposure of the eye or skin to the chemical. The longer the delay in the use of the solution the less likely it is to prevent or decrease the severity of the burn. Delayed washing with Diphoterine® can have a beneficial effect to stop the action of the chemical and return the tissue to a safe physiological state more quickly allowing treatment for the injury to commence. Diphoterine® cannot repair damaged tissue.

Diphoterine® solution is not currently recommended for first aid response to purely thermal burns. Cool running water for 20 minutes is the respected response for thermal burns

For combined thermal/chemical burns from chemicals used at high temperatures it is recommended to decontaminate the chemical injury first and then to treat the thermal burn. 

Due to its chelating properties, Diphoterine® solution can be used to decontaminate metals (as well as radionuclides such as uranium-238, cesium-137, strontium/yttrium-90, and cobalt-60).

For dust and chemically inert substances, Diphoterine® solution is  a sterile water-based solution and can therefore dilute and mechanically rinse efficiently however  AFTERWASH II®  is a comfortable isotonic rinsing solution and is more appropriate for dusts and other chemically inert substances.

 Diphoterine® solution can be used to efficiently rinse solid active chemicals. 


Diphoterine® solution will promote dilution of the solid pellets and neutralise them to stop or reduce the chemical injury dependent on contact time before irrigation.


The use of the Diphoterine® solution is not appropriate for white phosphorous exposures.

There will be no advers effect. Diphoterine® solution is non-toxic and non- irritating. It is not a sensitiser.

Diphoterine® solution is being studied for decontamination of caustic ingestion in a pig model.   Preliminary data indicate that it can be efficacious in this setting however it is not currently recommended for this purpose in humans.  Diphoterine® solution is non-toxic as the oral LD50 is greater than 2000 mg/Kg.

Studies show that using water or normal saline before or after Diphoterine® resulted in a worse outcome than if Diphoterine® was used as the only decontamination solution.

Using water or saline first provides only a passive wash and delays the application of the active washing solution (Diphoterine®) thus allowing the injury to develop.

Using water or saline after decontaminating with Diphoterine® only seeks to remove the active decontamination solution form the skin or eyes reducing its efficacy.

 

Diphoterine® solution should be used as quickly after the exposure of the skin or eye to the corrosive or irritant chemical and in sufficient volume. Our training and protocol information sheets advise on the suitable volumes required and responders must be aware that they should always use the full contents of the appropriate container.

Diphoterine® rapidly reduces the pain once decontamination starts so it is important to emphasise that the full container should be used to ensure full decontamination.

Remember: Do not stop when the pain stops - use the full contents.

Diphoterine® solution should be used as soon as possible after a chemical splash to skin or eyes.

Hexafluorine® solution should be used to decontaminate Hydrofluoric Acid and it's derivatives.

Diphoterine® is active against a very wide variety of chemical substances, therefore it  is well-suited for use with unknown chemical splashes.

No.

Diphoterine® solution has no physiological action on the eye or the skin.
It is registered as a Medical Device in Europe.

The 2-year shelf-life is to ensure :

  • That the product is replaced before it loses its sterility
  • That the washing solution conserves all of its properties
  • That the dispenser remains functional and retains optimal reliability for the end users

Prevor's patented eye wash systems fulfil various requirements, in particular those related to the principle of emergency washing in the workplace:

  • To allow any casualty to begin washing unaided.
  • To allow the casualty to correctly open the eye in order to improve washing efficacy.
  • To allow continuous and uniform washing of the cornea surface.

    The possibility of using the Morgan lens had been considered but dismissed, following various tests showing:
  • The difficulty of installing the lens in emergency situations, where the intervention time is limited
  • Washing is insufficiently uniform to be effective and a reproducible in all cases.

For these reasons Prevor conceived, developed and patented its own system of product delivery with an ergonomic eye cup.

The Morgan lens device is, in particular, designed to deliver the washing solution in the absence of medical personnel. This device could thus have an advantage in the case of a patient with multiple injuries or for the medical management of a large number of patients.
However, the ophthalmologists consulted do not recommend the use of a Morgan lens to carry out ocular washing following a chemical splash because the result is not likely to be sufficiently homogeneous. It has been noted that when a Morgan lens is used, the washing fluid follows the channels and created zones which were not irrigated by the instilled solution.

However, to be effective in the washing of a chemical splash, it is necessary to irrigate the full surface of the cornea and the conjunctival cul-de-sacs. We believe that a Morgan lens cannot guarantee the same advantages as manual washing carried out carefully by a specialist.

Note:
Description of a Morgan lens:
Tube connected to a perforated lens.
Diameter of the tube < 2 mm
Polystyrene lens glued to a tube.

Ophthalmologists consulted:
Dr Norbert Schrage, Clinique Ophtalmologique de Merheim
Dr Harold Merle, Centre Hospitalier de Fort de France

Diphoterine® solution, which acts directly on the chemical, results in a quick reduction in the sensation of pain. The anaesthetic is thus, in practice, often of no benefit. 

Anaesthetic use in the protocol of companies or in a hospital environment under medical ophthalmologic supervision could have only a complementary synergistic effect.

Diphoterine® solution actively binds and neutralises the chemical the decontamination residues are non-toxic and not ecotoxic.   Used Diphoterine® solution can be disposed of in the sewer system  - unlike water decontamination residues which will still have active chemical(s) present and should be disposed of as hazardous waste.

Hexafluorine® solution is a derivative of Diphoterine® solution, specifically designed to rinse eye and skin splashes of Hydrofluoric Acid or its derivatives and bind and neutralise both the corrosive H+ ions and  toxic F ions of Hydrofluoric Acid (HF).


Hexafluorine® solution can also decontaminate eye and skin splashes from fluorides in an acidic environment.

The Afterwash II® Solution assists in restoring the normal physiological state of the cornea after  Diphoterine® solution decontamination.   

It is also designed for rinsing of chemically inert dusts/particles from the eye.