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FINDINGS: Skin contact with liquid causes immediate severe pain (>50% solutions), pain delayed 1/2 to 6 hours after exposure (10% to 50% solutions), or pain delayed 6-24 hours after exposure (<10% solutions). HF is a weak acid, but fluoride is the most electronegative ion and is extremely toxic. It can cause extensive damage to skin and bone, and the systemic effects including hypocalcemia, hypomagnesemia, and hyperkalemia may produce fatal effects. This acid is also an inhalation hazard. The IDLH level set by NIOSH is 30 ppm. Chronic skin or respiratory exposure to HF can lead to osteosclerosis. [LaDou, p. 282, 439-43; AHLS, p. 107] TREATMENT: Calcium gluconate 2.5% to 10% in a topical gel can be applied after copious skin irrigation. 10% calcium gluconate can also be injected subcutaneously 0.5 ml per cubic cm of skin surface area. For systemic effects, 10% calcium gluconate or calcium chloride can be given IV, and 10% calcium gluconate can be given intra-arterially. [AHLS, p. 435-446] |
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