Treatment of severe hydrofluoric acid exposures

Previous publications on treatment of hydrofluoric acid exposures have given insufficient emphasis to immediate skin cleansing and prompt restitution of both serum and tissue calcium ion levels. Use of calcium gluconate topically as a 2.5% gel, in eyes as a 1% solution, and by nebulizer as a 2.5% or 3% solution has improved treatment results. Ten percent calcium gluconate solution may be given intravenously as indicated for hypocalcemia. Proper application of the calcium gluconate gel immediately after thorough washing of localized skin burns will produce relief of pain similar to that achieved by subcutaneous infiltration of 5% calcium gluconate solution. This may be used as an end-point for adequacy of treatment.