Medical management of hydrofluoric acid exposure

Hydrofluoric acid burns are usually due to accidental exposure. Deep tissue injury may result, damaging nerves, blood vessels, tendons, and bone. Concentrated hydrofluoric acid may cause immediate pain; dilute solutions may result in a delay of symptoms for many hours. Symptoms are usually out of proportion to the observed injury. Appropriate first aid and medical management can dramatically affect the prognosis. Local treatment consists of copious water lavage and the application of topical neutralization agents. For more severe exposures, calcium gluconate injection or intraarterial infusion of calcium gluconate may be indicated as well. Life-threatening alterations of electrolytes can occur, with ensuing arrhythmias. Inhalation, ingestion, and ocular exposures require specialized treatment and referral.