Survival after hypocalcemia, hypomagnesemia, hypokalemia and cardiac arrest following mild hydrofluoric acid burn

  title={Survival after hypocalcemia, hypomagnesemia, hypokalemia and cardiac arrest following mild hydrofluoric acid burn},
  author={Ming-Ling Wu and Juo-Fang Deng and Ju-Sing Fan},
  journal={Clinical Toxicology},
  pages={953 - 955}
Background. Although hydrofluoric (HF) acid burns may cause extensive tissue damage, severe systemic toxicity is not common after mild dermal exposure. Case. A 36-year-old worker suffered a first-degree burn of 3% of his total body surface area as a result of being splashed on the right thigh with 20% HF acid. Immediate irrigation and topical use of calcium gluconate gel prevented local injury. However, the patient developed hypocalcemia and hypomagnesemia, hypokalemia, bradycardia, and… 

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Adequate and timely calcium supplementation and ECMO application were the keys to successful treatment of the patient, who suffered from extensive HF burns combined with an inhalation injury led to a potentially fatal electrolyte imbalance and ARDS.

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This review highlights the mechanism of action, presents the acute and chronic symptoms, personal and general protective measures and devices that should be used, as well as decontamination procedures, immediate, antidote and hospital medical treatment.

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The case of a 48-year-old man who developed hypocalcemia and hypomagnesemia accompanied by hypokalemia-an interesting finding-following a chemical injury with exposure to 70% hydrofluoric acid is described.

Fatality due to acute hydrofluoric acid exposure.

Two fatal cases resulting from extensive exposure to hydrofluoric acid which produced acute systemic metabolic acidosis with profound hypocalcemia and hypomagnesemia are presented.

Hydrofluoric acid-induced hypocalcemia.

Treatment of two survivors, apparently the first two, of severe hypocalcemia caused by hydrofluoric acid is described, both intravenously and by subsechar injection, to replenish the biologically active calcium and to bind fluoride.

Systemic and topical effects of intradermal hydrofluoric acid.

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: Observations in one case and implications for mechanism of toxicity

Ventricular dysrhythmias due to HF toxicity seem to be independent of either hypocalcemia or hyperkalemia, and systemic toxicity after ingestions may be delayed and precipitous.

Studies on the treatment of hydrofluoric acid burn.

  • M. Murao
  • Medicine
    Bulletin of the Osaka Medical College
  • 1989
The results indicate that an HF skin burn results in systemic fluoride poisoning followed by hypocalcemia, hypersecretion of PTH, hyponatremia, hyperkalemia and other electrolytes imbalance.

Magnesium Homeostasis and Clinical Disorders of Magnesium Deficiency

Routine inclusion of serum Mg analysis in the electrolyte panel will enhance the clinical recognition and treatment of hypomagnesemic Mg-depleted patients, and close attention must be paid to optimizing K replenishment in hypokalemic patients by concurrent treatment of any accompanying hypomgnesemia to avoid the problem of refractory K repletion.

Hydrogen fluoride--the protoplasmic poison.

It is important for caregivers to remember that HF has distinct clinical signs and a specific antidote, namely calcium gluconate, which heightens the importance of being prepared for possible exposures.