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High-Pressure Hydraulic Injection Injuries

Hydraulic and diesel fuel systems operate at very high pressures, often 3,000 psi and above. If a loose connection or a defect in a hose should occur, a fine, high-velocity stream of fluid will result. Even for systems pressurized to as little as 100 psi, this fluid stream can penetrate human skin as if it were a hypodermic needle.

Initially, an accidental fluid injection beneath the skin may only produce a slight stinging sensation. There is a danger that one will ignore this, thinking it will get better with time. Most often it does not. Within a very short time the wound may begin to throb painfully, indicating tissue damage has already begun. Fluid injected directly into a blood vessel can spread rapidly through your circulatory system. The human body has little ability to purge these types of fluids. A fluid injection injury can become very serious or even fatal if not dealt with promptly and properly.

A medical doctor familiar with treatment of this type of injury must surgically remove the fluid within a few hours. The longer the delay in getting professional medical aid, the further the tissue damage can spread. If left untreated, the injury could result in disfigurement or amputation of the affected part.

Case Study
An operator was using a high-pressure hydraulic tool when the hose ruptured at the connector. As a result, high-pressure fluid came in contact with the operator’s hand. On presenting at the emergency room, the doctor’s initial orders were to keep clean and rest. The oil had already started to eat away fatty tissue in the hand and was traveling up the arm. The injured operator had five operations to cut away oil deposits and at one point faced the prospect of losing his arm.

How to Avoid High-Pressure Hydraulic Injection Injuries
• Never grab any hydraulic or diesel fuel connectors or hoses when they are subjected to higher pressures.
• Stop the engine and safely relieve all diesel fuel and hydraulic pressures before disconnecting any lines or otherwise working on these pressurized systems.
• Always ensure hoses are rated for pressures to which they will be subjected.
• Never use any hoses you suspect could be defective.
• Recognize that the source of the leak and the fluid streaming from it may be very small and not easily visible. You may only be able to see the fluid that accumulates as a result of the fluid stream.
• Keep all body parts well away from the area of a suspected fluid leak.
• Never search for leaks with your hands or any other body part.
• Only place the far end of a long object such as a piece of cardboard, wood or steel in the suspected path of any fluid stream.
• Recognize that your clothing – even heavy gloves – may offer little to no protection from a high-pressure fluid injection.
• Be sure to wear safety glasses or goggles for eye protection.
• Recognize that the source of the leak and the fluid streaming from it may be hidden behind other components of the equipment. If components are moved, the direction of the fluid stream could be aimed at you.
• Only use the far end of a long object such as a piece of wood or steel to move hoses or other obstacles.
• Follow lockout/tagout procedure – deactivate equipment to a zero energy state.

High-Pressure Injection Injury: Emergency Response
• Immediately transport the patient to the nearest hospital-affiliated emergency room or trauma center. If available, an ice or cold pack should be applied to the injection site to keep swelling down, but should not delay transport.
• Have the name of the chemical substance injected and the amount of pressure injected (e.g., 2,000, 6,000 or 10,000 psi) readily available for medical staff.
• The patient should not be discharged until a follow-up plan is discussed and clearly understood by both the patient and his or her supervisor.

The consequences of high-pressure hydraulic injection injuries are severe but generally not well known. Think about these potential consequences before you begin the search for the leaking hose or fitting.

About the Authors: John Boyle is Vice President of Safety and Quality for INTREN, an electric, gas and telecommunication construction company based in Union, Ill. Boyle has more than 27 years of experience, and has worked in nuclear and wind power generation and electric and gas distribution.

John Wisniewski is Manager of Safety for INTREN. Wisniewski has 25 years of experience, and has worked in automotive, petrochemical and wind power generation industries.

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