Hydrogen fluoride toxicity - Revision history

Danbot: Add MedicationDose entries for calcium gluconate, magnesium sulfate

2026-03-20T21:17:15Z

Add MedicationDose entries for calcium gluconate, magnesium sulfate

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 ==Complications==
 *Broncho[[pneumonia]] can develop within a week.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>
 ==See Also==

ClaireLewis at 17:19, 25 October 2020

2020-10-25T17:19:35Z

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	==References==		==References==
	<references/>		<references/>
			[[Category:Toxicology]]

Ihearttroponin: /* Complications */

2020-03-24T16:02:45Z

Complications

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	*Broncho[[pneumonia]] can develop within a week.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		*Broncho[[pneumonia]] can develop within a week.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>

	~~#REDIRECT [[Target page name]]~~
	==See Also==		==See Also==
	*[[Burns]]		*[[Burns]]

Ihearttroponin: /* See Also */

2020-03-24T16:02:31Z

Ihearttroponin: /* Disposition */

2020-03-24T16:01:52Z

Disposition

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	==Disposition==		==Disposition==
			*Consultation with poison center and burn center transfer per [[Burn center criteria]]
			*Admission for all patients with arrhythmia on ECG or severe electrolyte disturbance

	==Complications==		==Complications==

Ihearttroponin: /* Management */

2020-03-24T16:01:26Z

Management

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 **[[QTc prolongation]]
 **[[Ventricular tachycardia]]
 ==Management==
-*Treatment is supportive.
+*Decontamination: remove soiled clothing and irrigate thoroughly.
-**If [[hypocalcemia]] is present, administer nebulized [[calcium gluconate]] (1.5 ml of 10% calcium gluconate in 4.5 ml water) q4hr until normalization of serum calcium levels. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>
+*Mainstay of treatment is application of calcium to affected area.
-**In the absence of significant burns, consider steroids if symptoms do not improve. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>
 ==Disposition==

Ihearttroponin: /* Evaluation */

2020-03-24T16:01:06Z

Evaluation

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	==Evaluation==		==Evaluation==
			*Clinical diagnosis
			*Trend calcium, magnesium, and potassium levels
			**Hydrofluoric acid chelates calcium and poisons the Na+/K+ pump
			**Expect [[hypocalcemia]], [[hypomagnesemia]], and [[hyperkalemia]]
			*Monitor EKG for signs of electrolyte abnormality
			**[[QTc prolongation]]
			**[[Ventricular tachycardia]]

	==Management==		==Management==

Ihearttroponin: /* Background */

2020-03-24T15:59:39Z

Background

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	==Background==		==Background==
	*Hydrogen fluoride (HF) is a byproduct of standard fire suppression systems.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		*Hydrogen fluoride (HF) is a byproduct of standard fire suppression systems.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref> It is also used as rust remover and in glass etching, metal cleaning, and petroleum processing.
			*Oral ingestion has very high mortality rate
			*Onset and severity of symptoms correlated with concentration
			**Dilute solutions (<20%) may have delayed onset up to 24hr post-exposure
			**Moderate solutions (20-50%) develop symptoms within 1-8hr
			**Concentrated solutions (>50%) develop symptoms immediately
			***These patients are at highest risk for systemic toxicity/death
			***Pain immediately (even if wound appears minor) implies severe injury
			*Burn itself may appear relatively minor
			*Toxicity caused by binding of calcium and magnesium leading to electrolyte derangement and myocardial dysfunction

	==Clinical Features==		==Clinical Features==

ClaireLewis at 18:23, 31 December 2019

2019-12-31T18:23:13Z

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	==Clinical Features==		==Clinical Features==
	*Exposure to HF may result in rapidly progressive or fatal respiratory failure despite minimal external evidence of injury. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		*Exposure to HF may result in rapidly progressive or fatal [[respiratory failure]] despite minimal external evidence of injury. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>
	*Symptoms include shortness of breath, cough, or hypoxia; there must be a high level of suspicion for HF inhalation.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		*Symptoms include [[shortness of breath]], [[cough]], or [[hypoxia]]; there must be a high level of suspicion for HF inhalation.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Management==		==Management==
	*Treatment is supportive.		*Treatment is supportive.
	**If hypocalcemia is present, administer nebulized calcium gluconate (1.5 ml of 10% calcium gluconate in 4.5 ml water) q4hr until normalization of serum calcium levels. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		**If [[hypocalcemia]] is present, administer nebulized [[calcium gluconate]] (1.5 ml of 10% calcium gluconate in 4.5 ml water) q4hr until normalization of serum calcium levels. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>
	**In the absence of significant burns, consider steroids if symptoms do not improve. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		**In the absence of significant burns, consider steroids if symptoms do not improve. <ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>

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	==Complications==		==Complications==
	*~~Bronchopneumonia~~ can develop within a week.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>		*Broncho[[pneumonia]] can develop within a week.<ref>JOINT TRAUMA SYSTEM CLINICAL PRACTICE GUIDELINE (CPG ID: 12)</ref>

	==See Also==		==See Also==

Rossdonaldson1: /* Differential Diagnosis */

2019-12-28T00:27:53Z

Differential Diagnosis

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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Burn DDX}}

	==Evaluation==		==Evaluation==