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Survival after a massive hydrofluoric acid ingestion
1Department of Renal Medicine and Toxicology, Royal Prince Alfred Hospital, Camperdown NSW, Sydney, Australia.
Insights
Early, high-dose calcium therapy can be life-saving for severe hydrofluoric acid ingestion. This case demonstrates successful management of a lethal dose, preventing fatal arrhythmias and hypocalcemia.
Area of Science:
- Toxicology
- Emergency Medicine
- Cardiology
Background:
- Hydrofluoric acid (HF) ingestion is a medical emergency with a high mortality rate.
- Rapid development of hypocalcemia and fatal cardiac arrhythmias are the primary causes of death.
- Prompt and aggressive treatment is crucial for survival.
Observation:
- A 33-year-old male ingested a dose of hydrofluoric acid estimated to be six times the lethal dose.
- The patient experienced multiple episodes of ventricular fibrillation arrests.
- Despite the severe exposure, the patient survived with minimal long-term health consequences.
Findings:
- Survival was attributed to the early and aggressive administration of high-dose calcium therapy.
- Calcium was administered through both nasogastric and intravenous routes.
- This therapeutic approach effectively countered the systemic toxicity of hydrofluoric acid.
Implications:
- Early, high-dose calcium administration should be considered a critical intervention for severe hydrofluoric acid ingestion.
- This case highlights the potential for successful management even in cases of massive HF exposure.
- Aggressive calcium therapy may prevent life-threatening hypocalcemia and cardiac arrhythmias, improving patient outcomes.
Background:
Hydrofluoric acid ingestion is known to have a very high mortality rate secondary to the rapid development of hypocalcemia and fatal arrhythmias.
Case Report:
A 33-year-old man ingested an estimated dose of hydrofluoric acid 6 times that considered to be lethal. The patient survived with minimal morbidity despite having multiple ventricular fibrillation arrests. His survival is attributed to early, high dose calcium therapy given via the nasogastric and intravenous routes.