From: Jeffrey Lewin <jclewin**At_Symbol_Here**MTU.EDU>
Subject: Re: [DCHAS-L] HF concentration and gluconate gel
Date: Fri, 13 Oct 2017 18:29:28 +0000
Reply-To: ACS Division of Chemical Health and Safety <DCHAS-L**At_Symbol_Here**PRINCETON.EDU>
Message-ID: CAEwQnqj2m+5ZQkDfF1=8Lu1--x89FRx+aCeroCK7f4jNYMTHrw**At_Symbol_Here**mail.gmail.com
In-Reply-To <15f16f43d3b-c0a-45847**At_Symbol_Here**webjas-vac051.srv.aolmail.net>


Thank you, everyone, for the feedback.

I found the article Monona references (I see Dr. Hall is prominently mentioned) and have forwarded a link as a reference for my CHO's.

In the specific case I mentioned, we are leaning towards iced benzalkonium chloride as a first aid response. I'm going to encourage those working with stronger concentrations to stick with calcium gluconate.

It also prompted a good phone discussion with the director of our volunteer EMT responders. They do not carry gluconate (although our hospital is prepared to make it if needed) but they have talked through the scenario.

Jeff



On Fri, Oct 13, 2017 at 2:18 PM Monona Rossol <0000030664c37427-dmarc-request**At_Symbol_Here**lists.princeton.edu> wrote:
Alan, Can I publish a version of this in our newsletter? Either you can edit a bit or I will for your approval if you don't have time.

Monona Rossol, M.S., M.F.A., Industrial Hygienist
President: Arts, Crafts & Theater Safety, Inc.
Safety Officer: Local USA829, IATSE
181 Thompson St., #23
New York, NY 10012 212-777-0062
actsnyc**At_Symbol_Here**cs.com www.artscraftstheatersafety.org



-----Original Message-----
From: Alan Hall <oldeddoc**At_Symbol_Here**GMAIL.COM>
To: DCHAS-L <DCHAS-L**At_Symbol_Here**PRINCETON.EDU>
Sent: Fri, Oct 13, 2017 12:04 pm
Subject: Re: [DCHAS-L] HF concentration and gluconate gel

Jeff, Harry, et al,

I am a physician and a medical toxicologist and one of my particular interests is HF.

You want to go down to the auto parts store, you can buy 6-13% HF as a cleaning agent for "chrome wheels" or as a rust remover. There's a phosphoric acid product also avaiable.

I had a patient one bought one of these "rust/stain removers" and used it for 8 hours to clean windows in her house (no accounting for tastes - surprised the glass wasn't etched), didn't wear any gloves, and went to bed. Woke up in the middle of the night with really, really bad pain inher dominant hand. Dilute HF may not cause pain for several hours after exposure, but it is all out of proportion to the obvious clinical appearance.

Didn't want to wake up her primary care physician, so toughed it out until office hours. Told him she had used a usual windown cleaner. He treated her as an allergic reaction.

By the time we figured out it was HF, she lost her thumb and the first 2 fingers of her dominant hand.

Now, could probably be prevented. Stuff I can't discuss on this listserve, but we did do some good research on calcium gluconate at the Rocky Mountain Poison and Dru Center where I trained.

So my recommendation would be that whatever concentration HF you work with, having calcium gluconate gel available as a first aid measure would be a very good idea. Many employers provide 3 tubes: 1 in the worker's pocket, 1 in his/her locker in the changing room, and 1 in he medicine cabinet at home. To be used by inunction as soon as pain is perceived and then immediate going to whatever healthcare facility the employer uses, hopefully with prior instruction that HF is not "just another acid -- it can not only burn you, it can KILL you. I don't ever want to get another call about "our patient just died, can you tell us why?". (HF mistaken as being HCl.)

Alan
AlanH. Hall, M.D.
Medical Toxicologist



On Fri, Oct 13, 2017 at 10:28 AM, Harry Elston <helston**At_Symbol_Here**midwestchemsafety.com> wrote:
Jeff,
I'm not a physician here, but here's my take:
  1. Regardless of concentration in-use, having it on hand provides for good first aid practices.
  2. How did the end-user get to "low concentration?" Did they dilute a higher concentration solution?
  3. "Low concentration" tends to become "higher concentration" use over time because (nearly) every scientist believes "more is better". My observation of scientist nature over time. That circles the logic back to #1 above.
Honeywell's guide does give cutoff concentrations to define "dilute."
H
From: ACS Division of Chemical Health and Safety [mailto:DCHAS-L**At_Symbol_Here**PRINCETON.EDU] On Behalf Of Jeffrey Lewin
Sent: Friday, October 13, 2017 9:47 AM
To: DCHAS-L**At_Symbol_Here**PRINCETON.EDU
Subject: [DCHAS-L] HF concentration and gluconate gel
I received a cold call for gluconate gel kits this morning that I sent on to departmental CHO's. Someone asked if they should have kits available for low concentrations of HF (<0.1%).
Does anybody have a HF "cutoff" where they don't require/recommend kits be immediately available in the laboratory?
Jeff
--
Jeff Lewin
Chemical Safety Officer
Compliance, Integrity, and Safety
Environmental Health and Safety
Michigan Technological University
Houghton, MI 49931
--- For more information about the DCHAS-L e-mail list, contact the Divisional secretary at secretary**At_Symbol_Here**dchas.org Follow us on Twitter **At_Symbol_Here**acsdchas
--- For more information about the DCHAS-L e-mail list, contact the Divisional secretary at secretary**At_Symbol_Here**dchas.org Follow us on Twitter **At_Symbol_Here**acsdchas

--- For more information about the DCHAS-L e-mail list, contact the Divisional secretary at secretary**At_Symbol_Here**dchas.org Follow us on Twitter **At_Symbol_Here**acsdchas
--- For more information about the DCHAS-L e-mail list, contact the Divisional secretary at secretary**At_Symbol_Here**dchas.org Follow us on Twitter **At_Symbol_Here**acsdchas
--
Jeff Lewin
Chemical Safety Officer
Compliance, Integrity, and Safety
Environmental Health and Safety
Michigan Technological University
Houghton, MI 49931

O 906-487.3153
--- For more information about the DCHAS-L e-mail list, contact the Divisional secretary at secretary**At_Symbol_Here**dchas.org Follow us on Twitter **At_Symbol_Here**acsdchas

Previous post   |  Top of Page   |   Next post



The content of this page reflects the personal opinion(s) of the author(s) only, not the American Chemical Society, ILPI, Safety Emporium, or any other party. Use of any information on this page is at the reader's own risk. Unauthorized reproduction of these materials is prohibited. Send questions/comments about the archive to secretary@dchas.org.
The maintenance and hosting of the DCHAS-L archive is provided through the generous support of Safety Emporium.