Systemic intoxication following hydrofluoric acid exposure may be fatal. Patients need to be carefully monitored for complications and aggressively managed.
Systemic intoxication may follow:
(1) ingestion
(2) inhalation
(3) cutaneous exposure (may follow body surface area exposures >= 160 square cm)
It should be anticipated if the patient was exposed to a HF concentrations > 50%.
Clinical findings:
(1) weakness
(2) pallor
(3) malaise
(4) tachycardia
(5) hypotension
(6) CNS depression, which may progress to coma
(7) seizures
(8) tetany or carpopedal spasm
(9) pulmonary edema (may occur independent of inhalation exposure)
Complications of exposure route:
(1) respiratory failure
(2) gastrointestinal perforation
ECG findings:
(1) prolonged QT interval
(2) ventricular fibrillation
Laboratory findings:
(1) hypocalcemia
(2) hypomagnesemia
(3) hyperkalemia
(4) fluoride in the urine (assay may not be readily available)
(5) metabolic acidosis
(6) hyponatremia
(7) hyperphosphatemia
(8) hypoxemia
Cause of death:
(1) cardiac arrhythmia
(2) visceral perforation
(3) respiratory failure
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