HWN Suggests

Don't Get Burned by Hydrofluoric Acid Toxicity

Application of topical calcium gluconate gel turns the fluoride into an insoluble salt, preventing further absorption. This reduces the amount of tissue destruction and systemic toxicity. It is reasonable to initially apply the gel to affected areas every 30 minutes. Once pain is controlled, the frequency can be reduced to every 4 hours. Consider filling an examination glove with gel to treat hand burns.

read full article

Featured

 Early Bird Catches The Burn: Hydrofluoric Acid Treatment

After irrigation, the next step is NEUTRALIZATION of fluoride ions using 2.5% topical calcium gluconate gel.10 Neutralize fluoride ions by mixing 3.5g of calcium gluconate in 150 mL of water-based lubricant; apply generously to the affected area. Put a glove over the exposed dermal area, if it’s the hand that is affected or celophane wrap the region to keep the gel in place and prevent calcium loss.

Articles of Interest

First aid for a unique acid, HF: A sequel

Topical Gel (2.5%). Mix one 10-mL ampule (10%) per ounce of surgical gel (K-Y Lubricating Jelly; Johnson & Johnson). The gel must be kept above 40°F. Do not freeze.

Hydrofluoric acid

Hydrofluoric acid is found in car wheel cleaners, rust removal and glass etching solutions. Classically the person will present with pain out of proportion hours after dermal exposure. Unfortunately exposure can occur in almost every route and toxicity can be life threatening due to ventricular dysrhythmias secondary to hypocalcaemia, hyperkalaemia and hypomagnesaemia.

Hydrofluoric Acid Exposures

Hydrofluoric acid (HF) is a colorless acid typically found in an aqueous solution. However, HF can also be found as a gas above 19.5°C. HF is a common industrial chemical with a wide variety of uses. It is found in products used for glass and computer chip etching, porcelain and brick cleaning, metal electro polishing, petroleum processing, fluoridated hydrocarbon production, and leather tanning. Fluorinated hydrocarbons can also be found in many products like refrigerants, propellants, fire extinguishers, aluminum and chrome cleaning solutions, germicides, dyes, and rust removers. Ammonium bifluoride and ammonium fluoride found in wheel cleaner--although less caustic--can produce the same systemic toxicity as hydrofluoric acid when ingested or inhaled. HF can cause injury by ocular, dermal, respiratory and oral exposures.

Hydrofluoric Acid Related Injuries and Illness for First Responders

Systemic toxicity is a feared complication of acute HF exposure, especially in the potential setting of attacks against first responders, terrorist attacks, accidental exposures, riots, and protests.

Hydrofluoric Acid: The Burn that keeps on Burning

HF burns are more damaging and serious than other acidic burns because it causes tissue damage through two distinct mechanisms. The first, common to all acids, is by the rapid release of hydrogen ions and subsequent tissue dehydration and coagulation necrosis.

Mastering Minor Care: Hydrofluoric Acid Exposure

Hydrofluoric acid exposures occur in industrial settings, including semiconductor manufacturing, and are generally higher-risk due to higher concentrations' More frequent are exposures in commercial or residential settings with cleaning products, especially those targeted to air conditioners, rust removal, tires, or aluminum.

Resources

StatPearls

Ingestion of solutions or inhalation of fumes and vapors with unintentional and intentional exposures of hydrofluoric acid presents with dermal burns, eye injury, acute respiratory symptoms as well as causes systemic fluoride toxicity including cardiovascular, pulmonary, renal and neuromuscular symptoms, electrolyte imbalance and enzyme inhibition which can lead to cardiac arrhythmias and death.