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Survival following hydrofluoric acid ingestion
E S Stremski1, G A Grande, L J Ling
1Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
Annals of Emergency Medicine
|November 1, 1992
Summary
Hydrofluoric acid ingestion can cause life-threatening cardiac events like ventricular fibrillation due to electrolyte imbalances. Prompt calcium and magnesium treatment may prevent these severe outcomes in hydrofluoric acid poisoning.
Area of Science:
- Toxicology
- Cardiology
- Emergency Medicine
Background:
- Systemic toxicity from hydrofluoric acid (HF) exposure, particularly dermal, is known to cause hypocalcemia and hyperkalemia, potentially leading to fatal ventricular fibrillation.
- Cardiac toxicity following ingestion of HF is hypothesized but rarely documented due to rapid mortality.
Observation:
- A 70-year-old woman experienced two separate ingestions of an 8% HF solution.
- The first ingestion resulted in recurrent ventricular fibrillation, hypocalcemia, and hypomagnesemia.
- The second ingestion, treated more aggressively with calcium and magnesium, did not result in dysrhythmias.
Findings:
- This case series presents the first reported survival from ventricular fibrillation after hydrofluoric acid ingestion.
- Concurrent hypocalcemia and hypomagnesemia were observed, supporting the link between HF ingestion and electrolyte disturbances.
- Aggressive empiric administration of calcium and magnesium appeared to prevent cardiac dysrhythmias in the second episode.
Implications:
- Early and aggressive calcium and magnesium replacement should be considered in cases of hydrofluoric acid ingestion.
- This approach may be crucial for preventing life-threatening cardiac toxicity and improving survival rates.
- Further research is warranted to establish definitive treatment protocols for HF ingestion.