7 cases of hydrofluoric acid burn in which calcium gluconate was effective for relief of severe pain

Abstract

We report 7 cases of chemical burns due to hydrofluoric acid (HF). The patients suffered from severe pain. However, the pain was relieved after treatment with calcium gluconate. 6 out of the 7 cases were men. At the accidental exposures, all the patients had been engaged in washing or cleaning work and received burns on their hands and/or fingers. In one case, the forearm was also involved. During such work, all the patients had used rubber gloves, but the gloves had pinholes. For the treatments, 4% calcium gluconate jelly was applied in 5 cases and 4 of 7 were subcutaneously injected with 8.5% calcium gluconate. The involved nails were removed in 5 cases. It is concluded that physicians should provide calcium gluconate jelly and subcutaneous injections to treat an HF burn and should not hesitate to remove the involved nails. To prevent chemical burn due to HF, education and reeducation of workers regarding the hazard of this chemical are necessary.

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

“…Among all the chemicals resulting in chemical burns, HF could become the first most common substance to cause chemical injuries [3]. Moreover, the fluoride ion can be absorbed quickly through the skin and further result in secondary lesions, such as serious skin necrosis, hypocalcemia, and severe pain [4]. To effectively treat the patients with HF exposure, immediate specific and specialized medical measures seem to be essential.…”

Early surgical treatment by free flap reconstruction of hydrofluoric acid burn injury

“…It can penetrate through the skin and subcutaneous tissues as non-ionic form and lead to severe pain and progressive tissue necrosis. 1 Unlike minor HFA burns, deep burns caused by high concentrations of HFA require immediate treatment. Currently, however, most therapeutic recommendations focus on conservative treatment of minor HFA burns.…”

“…Treatment with 2.5% calcium gluconate gel and subcutaneous injection of 10% calcium gluconate solution into the affected area can be helpful, but they are sometimes ineffective when highly concentrated HFA is involved, with worsening local edema and pain. 1 Intra-arterial perfusion of calcium gluconate is available in cases of swollen and painful injured fingers. 3 However, arterial access, by the radial artery, is required and complications of arterial puncture include bleeding and arterial vasospasm.…”

A review of hydrofluoric acid burn management

“…Calcium gluconate gel can be made in the emergency department with a water-soluble lubricant, such as K-Y Jelly (Johnson & Johnson, USA), added to calcium gluconate solution or calcium gluconate powder (75 mL K-Y Jelly plus 25 mL of 10% calcium gluconate or 100 mL of K-Y Jelly plus 2.5 g of calcium gluconate) (8,18). The gel is applied every 30 min initially and massaged in, then applied every 4 h. A clinically reliable indicator of effectiveness is pain relief (19,20). The advantages of the gel are that it is easy to apply, painless and noninvasive; however, large quantities may be required and the impermeability of the skin to calcium limits its depth of penetration (21).…”