Resources and Memory //

who presents with right hand paraesthesias s/p possible exposure to HF 14 hours ago. Given duration of symptoms and history of exposure, likely low risk dermal exposure. In brief, hydrofluoric acid is usually found as a rust remover, used in glass etching or in the manufacture of silicon chips. While there is a higher risk of co-exposure with other acids in the workplace, this was likely not the case in regards to our patient. HF is both a dermal and respiratory irritant, however in our case, as patient was using a hood and given the questionable exposure, there is a low suspicion for cardiopulmonary symptoms at this time. As such, our patient currently does not demonstrate any overt inhalational symptoms including chemical pneumonitis or noncardiogenic pulmonary edema. While the concentration of HF exposure is unknown, if an exposure were to have happened, it is likely a weak or intermediate concentration as there currently is no overt signs of dermal injury. However, in weaker concentrations, there may be a delay of symptoms owning to the penetration of deeper tissues by the cytotoxic fluoride ions. As above, despite the low risk nature of exposure and relatively benign exam, after further discussion with poison control, we will obtain labs to evaluate for systemic hypocalcemia, hypomagnesemia and hyperkalemia. In the interim, the potential affected area will be irrigated extensively and if labs are unremarkable, given the time frame and history, will likely recommend continuation of topical calcium gluconate gel using a rubber glove to enhance skin penetration. At this time, given the constellation of symptoms, duration, non-progressive nature and unclear history of exposure, there is no acute indication for subcutaneous or systemic calcium administration.



[Back to Main Menu]