Hydrofluoric acid bums

Burns. Skin bums resulting from contact with pure fluorine gas are comparable to thermal bums and differ considerably from those produced by hydrogen fluoride (114). Fluorine bums heal much more rapidly than hydrofluoric acid bums. 

Precautions in Handling. Ammonium bifluoride, like all soluble fluorides, is toxic if taken internally. Hydrofluoric acid bums may occur if the material comes in contact with moist skin. Ammonium bifluoride solutions should be thoroughly washed from the skin with mildly alkaline soap as soon as possible however, if contact has been prolonged, the affected areas should be soaked with 0.13% solution of Zephiran chloride, or 0.2% Hyamine 1622 (Lonza, Inc.) or calcium gluconate, the treatment recommended for hydrofluoric acid bums. If any of these solutions come in contact with the eyes, they should be washed with water for at least 10 min and a physician should be consulted. 

Edelman P Hydrofluoric acid bums. State of the art reviews Occupational Medicine—The Microelectronics Industry. 1 89-103, 1986... 

Beiran, I., Miller, B., Bentur, Y. The efficacy of calcium gluconate in ocular hydrofluoric acid bums. Hum Exp Toxicol 16(4)), 223-228 (1997)... 

Wilkes, G. (2006), Hydrofluoric acid bums. In eMedicine.com. eMedicine Omaha. Last viewed October 10, 2006, http //VJVJVJ.emedicine.eom/emerg/topic804.htm... 

Hydrocinnamic acid, 16, 49 Hydrofluoric acid, 13, 46, 52 Hydrofluoric acid bums, 13, 48 Hydrogenation, 17, 45 Hydrogen bromide (anhydrous), 15,... 

B. Specific drugs and antidotes. For most agents, there Is no specific antidote. (See p 221 for hydrofluoric acid bums and p 302 for phenol bums.) In the past, corticosteroids were used by many clinicians in the hope of reducing scarring, but this treatment has been proved ineffective. Moreover, steroids may be harmful in the patient with perforation because they mask early signs of inflammation and inhibit resistance to infection. 

Hydrofluoric acid bums present a specific set of management problems (see p 221). Relevant occupations include not only the microelectronics industry but maintenance or repair jobs in which hydrofluoric acid-containing mst removers are used. 

While working with trifluoroacetic acid, a chemist handled a container with an ungloved hand, but unnoticed was a small liquid residue on the outside of the glass. After a few hours the chemist began to experience severe pain on the palm and the inside of the thumb from a serious hydrofluoric acid bum. The burn required a skin graft. (Trifluoroacetic acid reacts with water to produce hydrofluoric acid.)... 

American Industrial Hygiene Association Laboratory Safety Committee. Hydrofluoric Acid Bum from Trifluoroacetic Acid available at http //www2.umdnj.edu/eohssweb/aiha/accidents/chemicalexposure. htm Trifluoracetic (accessed August 15, 2009). 

The particular properties of HF forced the scientific community to understand its mechanism and its lesions kinetics (see Sect. 4.1.2.1). The idea was to find a way to improve the water washing. But the first improvement was to add, after initial decontamination with water, a secondary treatment such as to apply calcium gluconate as an ointment or by intravenous or subcutaneous injection. Topical applications are easier to perform but require repeated ointment based on patient s pain. Hydrofluoric acid bums are very painful. The pain depends on the concentration. If the concentration is higher than 50 %, the sensation of pain is immediate. If the concentration is less than 50 %, the pain and the lesions can be delayed. Calcium gluconate limits the evolution of the bum by binding fluoride ions but has only a light effect on H+ ions. 

Especially for hydrofluoric acid bums, the delay and the quality of management appear cmcial. 

Burgher F, Mathieu L, Lati E, Gasser P, Peno-Mazzarino L, Blomet J, HaU AH, Maibach HI. Experimental 70% hydrofluoric acid bums histological observations in an established hiunan skin explants ex vivo model. Cutan Ocul Toxicol. 2011 30(2) 100-7. doi 10.3109/15569527.2010.533 316. Epub 2010 Nov 15. Erratum in Cutan Ocul Toxicol. 2012 31(2) 174. 

Nguyen LT, Mohr 3rd WJ, Ahrenholz DH, Solem LD. Treatment of hydrofluoric acid bum to the face by carotid artery infusion of calcium gluconate. J Burn Care Rehabil. 2004 25(5) 421. ... 

Ohata U, Hara H, Suzuki H. 7 cases of hydrofluoric acid bum in which calcium gluconate was effective for relief of severe pain. Contact Dermatitis. 2005 52(3) 133-7. 

Dunser MW, Ohlbauer M, Rieder J, Zimmermann I, Ruatti H, Schwabegger AH, Bodrogi F. Critical care management of hydrofluoric acid bums a care report, review of the Uterature, and recommendations for therapy. Bums. 2004 30(4) 391-8. 

Another problem unique to hydrofluoric acid bums is delayed symptoms. Concentrations less than 20 percent may not produce symptoms for 24 hours. Symptoms of exposure to concentrations between 20 percent and 50 percent may be delayed for 1 to 8 hours. Concentrations above 50 percent produce immediate burning, pain, and tissue destruction. 

Edelman, Philip, Hydrofluoric Acid Bums, State of the Art Reviews -Occupational Medicine, The Microelectronics Industry, (J. LaDou, ed.), 1(1) 89-103, Hanley Belfus, Inc. Philadelphia, PA, (January-March... 

J. Chem. Educ., 1969,46, A171 Hydrofluoric Acid Bum Treatment . The treatment of HF burns has bwn in a state of flux in the past, with numerous remedies being tried. This presentation offers a somewhat different approach which centres around the use of certain high-molecular-weight quaternary ammonium compounds. The treatment consists basically in thorough and immediate flushing with water, followed by iced alcohol or aqueous Hyamine soaks. A review of over 200 case records confirms the efficacy of this treatment when compared with that in prior use, especially in the treatment of second-degree bums. 

Thomas, D., Jaeger, U., Sagoschen, L, Lamberti, C., Wilhelm, K., 2009. Intra-arterial caldum gluconate treatment after hydrofluoric acid bum of the hand. Cardiovascular and Interventional Radiology 32 (1), 155-158. 

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