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Medical Management of Hydrofluoric Acid Exposure

Author: Upfal M, Doyle C, Department of Family Medicine, Wayne State University, Detroit, MI 48201

Journal: J Occup Med 1990 Aug;32(8):726-31

Abstract: 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 ensuring arrhythmias. Inhalation, ingestion, and ocular exposures require specialized treatment and referral.

A 60-year-old female splashed cleaning solution in her eyes.  She was irrigated with the Morgan Lens until pH returned to normal.  Afterwards, she told me, "You know, contact lenses are a lot more comfortable than I thought. Maybe I should get some!".  Her chemical conjunctivitis resolved nicely without sequelae. A clinical success.

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The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.