Emergency services arrived on the scene and requested a helicopter emergency medical service (Doctor Heli), which transferred the patient to our hospital. The patient started to complain of dyspnea and chest discomfort, and his general condition gradually worsened while waiting for the ambulance. After the injury, his lower body was continuously washed with running water for 20 min by his colleagues until an ambulance arrived. HFA splashed on his lower body, and he immediately washed himself with water. Immediately after he entered the area, the tank exploded. He was wearing goggles, a gas mask, and long boots. However, a 57-year-old man (the patient) entered the area at 9:35 in order to examine the state of the accident. No individuals were close to the tank when the leakage occurred. Case reportĪccidental leakage of hydrogenfluoric Acid (HFA) from a tank occurred at 8:45 in the morning. The case followed a lethal course despite the rapid and continuous administration of calcium with intensive care, which allowed the patient to survive for 7 hrs. We experienced a case of chemical burns involving 50% HFA exposure, which resulted in third-degree burns over 30% of the body. Despite its hazardous nature, the risk of HFA burns is not well recognized, even to those who handle this material. HFA can cause intractable arrhythmia induced by hypocalcemia, hypomagnesemia, and hyperkalemia, resulting in death. Hydrofluoric acid (HFA) is widely used in both domestic and industrial materials for cleaning glass, metal, and brick. Key wordsĪrrhythmia, calcium gluconate, chemical burn, hydrofluoric acid, hypocalcemia Introduction This case serves as a warning to persons handling HFA, emergency physicians and dermatologists, who should recognize the corrosive nature and the potential risks of HFA to avoid tragic outcomes. Our patient was able to survive for 7 hrs, perhaps because of the early and intensive administration of calcium formulation and intensive care. In many reported cases of exposure to high-concentration HFA, death from fatal arrhythmia occurred within 1hr. Further, we administered a massive transfusion of saline with catecholamine for the treatment of shock. We amputated his leg in order to prevent systemic spreading of HFA. However, hypocalcemia was prolonged, fatal arrhythmia appeared, and we started the continuous administration of calcium gluconate. 10 mL of calcium gluconate solution (8.5% calcium gluconate) had been already administered before arrival to the emergency room. He was transferred to our hospital by a helicopter emergency medical service (Doctor Heli). A 57-year-old man received lower body injuries from splashes of 50% HFA solution by an accident. HFA can cause lethal arrhythmia due to hypocalcemia and hypomagnesemia, particularly in cases of high-concentration HFA exposure. Chemical burns from Hydrofluoric Acid (HFA) are poorly recognized, even though we sometimes encounter patients affected by these burns.
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