Hydrofluoric acid (HF)
- Hydrofluoric acid (HF) is found in industrial cleaning agent for metals / glass or in household rust removing agents.
- HF is an extremely caustic inorganic acid.
- Fluoride ion penetrates skin and permeates deep tissues (incl. bone).
- Fluoride binds calcium forming insoluble salts.
- ↓↓Ca++ in local tissues → cell necrosis.
- Local tissue death → local K+release irritating nerve endings = pain ++.
- HF burns may present early (severe pain, HF conc. usually >20%) or late.
- Typically, very intense (± delayed) pain.
- Systemic toxicity due to ↓Ca++, ↓Mg++, ↑K+ → arrhythmia.
- Manage systemic toxicity.
- Local pain control.
- Prevention of progressive tissue damage.
Local toxicity / burn
- Wash (repeatedly) with Diphoterine (cylinder in decontamination room in CUH ED).
- Topical calcium gluconate.
- Local Ca++ gluconate infiltration.
- "Biers block"
- 10-20 ml Ca++ gluconate diluted to 40ml.
- Leave cuff inflated for 15 minutes.
- Early release of cuff may cause flushing, headache, and
- Intra-arterial Ca++ gluconate.
Content by Dr. Íomhar O' Sullivan 27/04/2011. Last review Dr IOS 18/09/14.