Water jetting injury research achieves global reach

Jul 4, 2023 | Featured Article, Lifting The Lid

A study commissioned by the Water Jetting Association (WJA) into the management of high-pressure fluid injection injuries has become one of the most important research papers on the topic in the world.

The study has been accessed online more than 10,000 times since it was published in 2019, and has been cited in five specialist medical papers over the same period.

Now, a water jetting injury treatment guide developed from the research has been extensively redesigned to make it easier to use.

Water jetting is essential for a huge range of tasks, including pressure washing, cleaning tubes and chambers in oil and gas, petrochemicals and energy plants, de-fouling ships and marine structures, hydro-demolition of concrete, sewer and tank cleaning, and precision materials cutting.

Operator water jetting


Practical guidance

The WJA water jetting injury treatment algorithm gives step-by-step best practical guidance on the treatment of water jetting injuries from first response through to definitive hospital care.

It has been praised as a game-changer in aiding effective responses to water jetting injuries which, if not treated correctly, can result in life-changing and sometimes fatal consequences.

The WJA-funded research was led by Dr Sancho Rodriguez-Villar, an intensive care consultant at King’s College Hospital, London, and Dr Robert Charles Kennedy (PhD), the WJA’s Clinical Research and Development Advisor.

“The study is clearly one of the most important sources of expert opinion on high-pressure fluid injection injuries in the world,” explains Dr Rodriguez-Villar. “It is a complex multidisciplinary piece of research involving knowledge from industry and three medical specialties.

“It is highly likely that doctors and surgeons around the world are searching for advice on such injuries, finding this research, and using it to guide their treatment.

“The study is having the desired and very important effect of educating clinical teams about how to treat these unique and serious injuries. This, in turn, will be greatly improving the treatment outcomes for patients, contributing to their long-term health and wellbeing, and possibly saving lives.”

The WJA is the member organisation for the water jetting industry in the UK. Its codes of practice and City & Guilds-accredited training courses are respected for setting water jetting standards in the UK and internationally.

The study, called the Management of Industrial High Pressure Fluid Injection Injuries (IHPFII): the Water Jetting Association Experience with Water Driven Injuries, is published in the European Journal of Trauma and Emergency Surgery.

It is also available via the medical database Researchgate. The WJA funded a publishing agreement to allow it to be free to download, to ensure it is seen and used as widely as possible.


Low-pressure injuries

IHPFII injuries can be caused with water pressures as low as seven bar, or 100 pounds per square inch (PSI) – while water pressures for industrial applications can exceed 1,700 bar, or 24,650 psi.

They are characterised by small entry wounds, caused by fine fluid jets, and no exit wounds. This can mask the extensive internal disruption they can cause. Debris and bacteria can be also carried far into the body, increasing the risk of serious infection.

These factors can lead to delays in patients receiving the appropriate emergency treatment. This can result in complications that, in worst cases, cause life-changing serious injury or death.

The WJA water jetting injury treatment algorithm is designed to help first aiders, paramedics and clinicians optimise treatment and make correct treatment decisions throughout a patient journey, reducing the risk of death, long-term disability or unnecessarily prolonged periods of recovery.

The WJA has now created an A4 version which is easier to view, both online and offline. Its sections have also been colour-coded so users can easily follow a patient’s journey through a treatment pathway.

“The evidence shows that, without early and correct intervention, the outcome for those injured is often catastrophic,” says Kennedy. “We strongly advise all parties to observe the WJA’s algorithm for the management of high-pressure injection injuries.”

The algorithm can be instantly accessed via a red tab on the home page of the WJA website.


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