HF poisoning

 

Substance

-      Hydrofluoric acid

Common name or Trade name

-       氫氟酸

- 用途: 磨光玻璃,  金屬除鏽，半導體工業[1].

 

Involving system

- depends on the route of exposure  

 - electrolyte imbalance

-       Skin necrosis if contact injury.

 

Presentation 

-     hypocalcemia [1,2]

- hyperkalemia [1]

- hypomagnesemia [1]

- arrhythmia, VT, Vf [2].

-extreme high T wave in ECG [2]

 

Antidote and Treatment

- skin decontamination [1]; activated charcoal is not indicated.

-     Sincal; Calcium gluconate [2]

- milk in ingested HF case [2].

- NG decompression rather than irrigation [1].

- ACLS

Disposition 

-       lethal dose: 1.5gm, or 20mg/kg.

  - ICU care when arrhythmia/life-threatening condition or massive burn injury,

50% solution > TBSA 1%;

TBSA > 5%;

> 60% solution inhalation injury.

Swallowing/ingestion injury.

 

REFERENCES

[1]. 急診醫學會, AILS三版, p. 247—254.

[2]. Su YJ, Lu LH, Choi WM, Chang KS. Survival after massive hydrofluoric acid ingestion with ECG changes. Am J Emerg Med. 2001 Sep;19(5):458-60. doi: 10.1053/ajem.2001.24503. Erratum in: Am J Emerg Med. 2009 Jan;27(1):126. PMID: 11555812.

 

Dec 28, 2020, edited by Yu-Jang Su.