Prompt neutralization of hydrofluoric acid can significantly reduce the extent of tissue injury and can be helpful in controlling the intense pain.
Formula weight for calcium gluconate, anhydrous: 530.4 g
Type of neutralizing treatments:
(1) topical
(2) subcutaneous injection
(3) intravascular infusion
(4) ocular drops
(5) inhalation nebulizer treatment
Preparation of topical ointment - 2.5% calcium gluconate:
(1) 3.5 grams calcium gluconate USP powder with 5 ounces (140 g) surgical lubricant
(2) 2.5 grams of calcium gluconate USP powder plus 100 g surgical lubricant
(3) 25 mL of 10% calcium gluconate solution plus 75 g surgical lubricant
Preparation of topical ointment - alternative:
(1) 1.3 grams benzylalkonium chloride in 1 liter iced water (0.13% Zephiran solution)
(2) 2 grams of benzethonium chloride in 1 liter iced water (0.2% Hyamine solution)
Application of topical ointment:
(1) The ointment is applied liberally and often until the pain stops.
(2) The sites should be inspected and redressed at least every 4 hours.
(3) Hand burns may be covered with a surgical glove after application of the gel
Preparation of solution for subcutaneous injection - 5% calcium gluconate:
(1) 5 mL of 10% calcium gluconate solution plus 5 mL sterile water or saline
Application of solution for subcutaneous injection:
(1) Inject 0.5 mL per square cm of exposed skin surface with a 27 or 30 gauge needle.
(2) Injection into the hand or digit can result in a compartment syndrome. Do not inject more than 0.5 mL per digit.
Preparation of intravascular infusate - 10% calcium gluconate:
(1) For systemic intoxication, the 10% solution is infused intravenously.
(2) For infusion into an affected extremity, a 2.5% solution may be used made by mixing 10 mL of the 10% solution with 30 mL of 0.9% saline.
Preparation of ocular drops: 1% calcium gluconate eye drops.
Preparation of nebulizer solution - 2.5% calcium gluconate
(1) 0.15 g calcium gluconate plus 6 mL sterile water or 0.9% saline, OR
(2) 1.5 mL of 10% calcium gluconate solution plus 4.5 mL sterile water or 0.9% saline
Specialty: Toxicology, Emergency Medicine, Critical Care