Garry Wilkes, MBBS, FACEM Director of Clinical Training (Simulation), Fiona Stanley Hospital; Clinical Associate Professor, University of Western Australia; Adjunct Associate Professor, Edith Cowan University, Western AustraliaDisclosure: Nothing to disclose. [2], There are three (3) routes of entry for hydrofluoric acid into the human body - skin / eye exposure, inhalation and ingestion. Hydrofluoric acid (HF) contact with skin can cause severe chemical burns. Make sure that the clothing comes into contact with as little skin as possible as it is removed. This article was co-authored by Anthony Stark, EMR.
The Calcium gluconate gel will turn white as the calcium binds to the fluoride ions creating Calcium fluoride (CaF). Structural firefighters' protective clothing provides limited protection in fire situations ONLY; it is not effective in spill situations where direct contact with the substance is possible. Decontamination procedures using a soft brush, moving in a downward motion (from head to toe) with household dish soaps (Dawn, Palmolive) and water, with a pH value of at least 8 and should not exceed a pH value of 10.5, will help neutralize hydrofluoric acid with a low pH. doi: 10.1503/cmaj.181078.
Epub 2014 Jan 24. You don't want to induce vomiting.
Specific treatment includes the following: Provide 100% oxygen by mask, 2.5% calcium gluconate by nebulizer with 100% oxygen, continuous pulse oximetry, ECG, and clinical monitoring. Holla R, Gorter RR, Tenhagen M, Vloemans AF, Breederveld RS. Despite concerns of perforation, consider gastric lavage with calcium chloride (ie, 20 mmol calcium in 1000 mL normal saline solution) early in overdose. Clinical toxicology (Philadelphia, Pa.). Dibbell DG,Iverson RE,Jones W,Laub DR,Madison MS, Hydrofluoric acid burns of the hand. Ann Emerg Med. Do not get water inside containers. 2017 Feb. 43 (1):e1-e6. The binding of the fluoride ion to the calcium and magnesium will produce hypocalcemia and hypomagnesemia as well as the destruction of the underlying tissue. Instruct patients to keep affected digits in a latex glove for 24 hours to maximize gel penetration. Subcutaneous infiltration may be indicated for elsewhere at 0.5 ml/cm(2) burn of 10% calcium gluconate. Please help us continue to provide you with our trusted how-to guides and videos for free by whitelisting wikiHow on your ad blocker. Stuke LE, Arnoldo BD, Hunt JL, Purdue GF. Pain from exposure may be controlled with opioids prescribed by your physician, Hydrofluoric acid is corrosive and penetrates tissue quickly, causing pain, nerve, and bone damage. Death has occurred within 90 minutes of ingestion of HF contained in rust remover. Survival after hypocalcemia, hypomagnesemia, hypokalemia and cardiac arrest following mild hydrofluoric acid burn. Most commonly used decontaminating procedure is rinsing with cold or warm running water or saline for at least 30 minutes. 2008 Nov-Dec. 29(6):893-6. Drink 4 to 8 ounces of these liquids to help. 29(3):541-3. If used as a definitive treatment, 2.5% calcium gluconate should be applied 4 to 6 times daily, for 3 to 4 days.
Edward A Michelson, MD Associate Professor, Program Director, Department of Emergency Medicine, University Hospital Health Systems of Cleveland SMALL SPILL: Cover with DRY earth, DRY sand or other non-combustible material followed with plastic sheet to minimize spreading or contact with rain. Yuanhai Z, Liangfang N, Xingang W, Ruiming J, Liping L, Chunjiang Y, et al. You can also use hexafluorine, which is a chemical compound that has also been used extensively for HF burns. Results: Chest x-rays should be performed on all patients with respiratory exposure to evaluate for pulmonary edema or pneumonitis. Joe Alcock, MD, MS Associate Professor, Department of Emergency Medicine, University of New Mexico Health Sciences Center Procedures, 2001 It may provide little or no thermal protection. Urinalysis with evaluation for hematuria and proteinuria will indicate renal dysfunction, insufficiency and renal cortical necrosis. Int Wound J. Burns. Potentially fatal electrolyte imbalance caused by severe hydrofluoric acid burns combined with inhalation injury: A case report. Hydrofluoric acid burns present with a unique concern for systemic fluoride toxicity including cardiovascular, pulmonary, renal and neuromuscular symptoms, electrolyte imbalance and enzyme inhibition which can lead to cardiac arrhythmias and death.
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