Two Cases of Chemical Burns by Hydrofluoric Acid

불화수소산에 의한 화학화상 2례

  • Jang, Sung-Won (Department of Emergency Medicine, School of Medicine, University of Keimyung, Dongsan Medical Center) ;
  • Sohn, You-Dong (Department of Emergency Medicine, School of Medicine, University of Keimyung, Dongsan Medical Center) ;
  • Choi, Woo-Ik (Department of Emergency Medicine, School of Medicine, University of Keimyung, Dongsan Medical Center) ;
  • 장성원 (계명대학교 의과대학 동산의료원 응급의학교실) ;
  • 손유동 (계명대학교 의과대학 동산의료원 응급의학교실) ;
  • 주명돈 (계명대학교 의과대학 동산의료원 응급의학교실) ;
  • 최우익 (계명대학교 의과대학 동산의료원 응급의학교실)
  • Received : 2006.08.17
  • Accepted : 2006.11.14
  • Published : 2006.12.30

Abstract

Hydrofluoric acid is a colorless gas or fuming liquid with a strong, irritating odor. Hydrofluoric acid burns are uncommon; however, if severe burn occur, they caused death from systemic effects, such as fatal cardiac arrthmia. We experienced two cases of hydrofluoric acid chemical burns on digits. These patients had typical clinical features of hydrofluoric acid chemical burns, such as pulsating pain at the burn site, as well as ischemic and necrotic skin changes. The hydrofluoric acid chemical burn was confirmed by a history of exposure. Subsequently, we made a calcium gluconate gel by mixing 20% calcium gluconate, an antagonist against hydrofluoric acid, with lubricant, and we injected 10% calcium gluconate subcutaneously when they complained of pain rated at higher than 5 on the pain scale. Simultaneously, we monitored the patients' electrocardiographs and checked their serum total calcium, ionized calcium, and magnesium levels serially. Clinical presentations and the emergency management of hydrofluoric acid chemical burns were reviewed along with the current literature. These patients were discharged without any significant complications.

Keywords

References

  1. Hatzifotis M, Williams A, Muller M, Pegg S. Hydrofluoric acid burns. Burns 2004;30:156-9 https://doi.org/10.1016/j.burns.2003.09.031
  2. Burd A. Hydrofluoric acid-revisited. Burns 2005; 30:720-2 https://doi.org/10.1016/j.burns.2004.07.001
  3. Kenneth JD. Hydrofluoric Acid Burns This liquid and its vapor can produce potentially fatal chemical burns. Am J Nurs 2001;101:24AAA-DDD
  4. Kim DC, Kim DH, Jang YC. A Clinical Study of Chemical Burns. J Korean Soc Plast Reconstr Surg 1997;24:122-32
  5. Dunser WM, Ohlbauer M. Critical care management of major hydrofluoric acid burns: a case report, review of the literature, and recommendations for therapy. Burns 2004;30:391-8 https://doi.org/10.1016/j.burns.2004.01.005
  6. Kirkpatric JJR, Enion DS, Burd DAR. An algorithmic approach to the treatment of hydrofluoric acid burns. Burns 1995;21:485-94
  7. Holstege C, Baer A, Brady JW. The electrocardiographic toxidrome:the ECG presentation of hydrofluoric acid ingestion. Am J Emerg Med 2005; 23:171-6 https://doi.org/10.1016/j.ajem.2004.04.032
  8. Kim KJ, Park SH. The Effect of Topical Calcium Gluconate Jelly in Hydrofluoric Acid Burn. Kor J Dermatol 1997;35:744-51
  9. Kirkpatric JJR, Enion DS, Burd DAR. Hydrofluoric acid burns : A review. Burns 1995;21:485-94
  10. Cho BH, Kim KJ, Kang HJ. Clinical Study of Hydrofluoric Acid Burn. Kor J Dermatol 1993; 31:672-80
  11. Wedler V, Guggenheim M, Moron M, Kunzj W, Meyer EV. Extensive Hydrofluoric Acid Injuries:A Serious Problem. J Trauma 2005;50:852-7
  12. Lin TM, Tsai CC, Lin SD, Lai CS. Continuous Intra-Arterial Infusion Therapy in Hydrofluoric Acid Burns. J Occup Environ Med 2000;42:892-7 https://doi.org/10.1097/00043764-200009000-00008