Date: Tue, 1 Nov 2011 12:31:52 -0600
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From: Alan Hall <ahalltoxic**At_Symbol_Here**MSN.COM>
Subject: Re: Hydrofluoric acid burns
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I assume you are asking about the initial first aid decontamination of HF burns, rather than definitive medical treatment of developed burns and the potential systemic toxicity seen with concentrated or anhydrous HF exposures.
Some of what you recommend may depend on the concentration of the HF involved.  Delayed onset of pain (way out of proprtion to the clinical findings) may not develop for hours after exposure to concentrations of 20% orless, for example.  One author called dilute HF "the stealth acid" for this reason.
If you are based in the US, then you should consider initial waterdecontamination following the ANSI/ISEA Z358-1-2009 Standard, although some experts would recommend a shorter time of water flushing (perhaps 5 minutes or so rather than the 15 minutes recommended with other types of corrosive chemical exposures).  Following this, there are a number of alternatives.  If you contact a Poison Center or a Medical Toxicologist, they may most likely recommend topical inunction of a 2.5% calcium gluconate gel product.  Those in Occupational Medicine may recommend iced benzalkonium chloride soaks (care must be taken to prevent adding frostbite injury to the chemical skin injury).  To my reading of the literature and experience, these seem to be about equally efficacious.  There are also recommendations for use of other calcium- or magnesium- salts, either as pastes or gels or soaks.  I am personally less impressed with the results of these.
Honeywell, the largest producer of HF worldwide, has some excellent data and first aid/decontamination recommendations, and the last time I looked you could just google them and download the latest version of their recommendations.  They also have periodic webinars and you might investigate participating in one of these, although I think they are usually reserved for Honeywell customers.
There is another option outside the US, but as I am a consultant to the manufacturer, I will say no more in this forum.  This option is notcurrently available in the US.
Eye exposures are more problematic.  There are anecdotal accounts and recommendations for use of dilute calcium gluconate solutions.  These are not "evidence based" and the data on efficacy and safety are rathersparse.  Keep in mind that HF eye exposures act and look much more like concentrated base exposures (such as NaOH) rather than acid eye injuries.  Severe visual impairment or even globe penetration can occur. 
Inhalation exposures pose another problem, although many occupational physicians (based again on anecdotal evidence only) will use a nebulized calcium gluconate solution.
Ingestion exposure would be extremely unlikely in an industrial or laboratory setting, so I will not discuss these here.
Further treatments can involve subcutaneous injection of calcium gluconate only (calcium chloride must never be used for this purpose), and various technigues for intravenous or even intra-arterial injection/infusion of calcium gluconate.  Then there is the entire other issue of medical/surgical treatment of HF burns, again outside the scope of this forum.
The treatment of systemic toxicity from absorption of HF is beyond the scope of this forum, but we should remember that HF is not only a chemical that can burn you, it can kill you with sufficient exposure.
Hope this is useful.
Alan H. Hall, M.D.
Medical Toxicologist


Date: Mon, 31 Oct 2011 23:24:00 -0400
From: ernielippert**At_Symbol_Here**TOAST.NET
Subject: [DCHAS-L] Hydrofluoric acid burns

What is the current best protocol for the treatment of hydrofluoric acid burns? Has the Honeywell publication "Recommended Medical Treatment for Hydrofluoric Acid Exposure", Ver. 1.0, May 2000 been superseded?
Ernest Lippert

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