Hydrofluoric burns treatment

What’s the fuss?

Chemical burns are a common workplace risk, yet some are more harmful than others. Hydrofluoric acid (HF) is one of the strongest inorganic acids, so contact with a small amount of HF can be deadly- burn covering only 2.5% of your body surface area is enough to cause death. Pain is not felt immediately after an HF burn increasing the chances of the injury going unnoticed and increasing its severity. However, there are ways to protect yourself and treat more severe burns.

Exposure usually is unintentional and often is due to inadequate use of protective measures.

In America, more than 1000 cases of HF burns are reported annually.  The actual incidence rate is unknown.

Who’s most at risk?

• HF is used mainly for industrial purposes. It is used in glass etching, electronics, manufacturing and metal cleaning. Although it is most commonly found in industry, it can also be found in household products such as rust removers.

• The majority of exposure is usually to a small area of skin, most commonly on the hands and fingers.

• Statistically, males are more at risk of HF burns than women. This can be explained by occupational patterns.

• The majority of HF exposure occurs in adults, thus adults are more at risk than children and the elderly of suffering HF-related injuries.

What are the symptoms?

HF causes a corrosive burn, and dilute solutions deeply penetrate before dissociating, thus causing delayed injury and symptoms. Burns to the fingers and nail beds may leave the overlying nails intact, and pain may be severe with little surface abnormality.

Local effects of hydrofluoric acid burns include tissue destruction and necrosis. Burns may involve underlying bone.

Systemic fluoride ion poisoning from severe burns may be associated with hypocalcemia, hyperkalemia, hypomagnesemia, and sudden death.

First aid regarding HF burns at work:

Any injury resulting from an exposure to HF acid is serious and assistance goes far beyond the capacity of a basic first aider. HF acid is corrosive and penetrates tissue quickly, causing pain, nerve, and bone damage. Medical assistance is always required in any case of exposure, yet the seriousness of the injury is variable.  If exposure is external, it is serious and must be treated immediately. If exposure is internal, however, the case is much more serious and medical assistance should be called for immediately.

External exposure:

Skin contact:

• Stay with the casualty- get another person to call an ambulance.

• Flush the burnt area under a hose or suitable safety shower. Continue for at least fifteen minutes.

• Immediately remove contaminated clothing- this will prevent the acid from any more potential skin contact.

• Massage calcium gluconate gel liberally into the burn- continue for about 20 minutes.

• Immerse the burn area in a solution of 0.2% iced aqueous Hyamine 1622 or 0.13% iced aqueous zephiran chloride, if available. If you cannot immerse the burn, soak a towel in one of the solutions above and gently press it onto the burn. Change the towel every two minutes if possible.

• Once taken to hospital, a sterile aqueous solution of 10% calcium gluconate will be injected beneath, around, and in the burn area.

Eye contact:

• Stay with the casualty. Get another person to call an ambulance.

• Flush the eyes with water for at least thirty minutes.

• If only one eye is contaminated, be careful not to wash acid into the other eye.

• Keep the eyelids apart and away from the eyeballs whilst washing.

• Apply an ice pack to eyes until the ambulance arrives, or taken to the emergency room.

Internal exposure:

Inhalation:

• Call an ambulance immediately.

• If the victim is unconscious, keep them warm (i.e. using blankets)

• If necessary, administer CPR until medical assistance arrives.

Ingestion:

• Call an ambulance immediately.

• Drink copious amounts of water in order to dilute the ingested acid.

• Do not induce vomiting- this may cause more damage.

Summary:

• HF acid is commonly found in industrial workplaces.

• HF acid is corrosive- it can cause damage to nerve endings, bones and organs.

• Exposure to only a small amount is enough to cause fatality.

• If an individual suffers an HF burn, it is imperative that an ambulance is called immediately.

• The effects of HF burns are not always immediately obvious. If you are not sure whether or not you have been exposed to HF acid, treat the case as though you have and seek immediate medical help.