What is Hydrofluoric Acid Poisoning?

• Hydrofluoric acid is an inorganic compound. It is a clear solution with an irritating smell that is formed by mixing hydrogen fluoride gas in water
• Hydrofluoric acid is an acutely toxic substance that can cause severe and permanent eye and lung injuries on exposure. It is also highly-corrosive in nature and can burn through skin and tissues
• Hydrofluoric acid has a wide range of industrial and commercial applications. It is used in refining oil, production of various compounds that are precursors to many polymers and refrigerants, in the production of inorganic fluorides, and as an etching and cleaning agent
• Hydrofluoric Acid Poisoning is the accidental or intentional intake of any product containing the compound. The exposure may be through skin or eye contact or following ingestion/inhalation of the chemical
• The condition is diagnosed based upon the clinical history, combination of signs and symptoms, and additional tests (that may include, in some cases, radiological studies and laboratory tests)

Hydrofluoric Acid Poisoning may be also referred to variously as the following:

• Fluorhydric Acid Poisoning
• Hydrofluoric Acid Toxicity
• Hydronium Fluoride Poisoning

What are the Causes of Hydrofluoric Acid Poisoning?

• Hydrofluoric Acid Poisoning is caused by the ingestion of hydrofluoric acid (liquid). The exposure may also be through direct skin or eye contact
• Inhalation of the corrosive acid vapors may lead to severe respiratory problems
• This intake could be accidental, or in some cases intentional, to bring self-harm
• Hydrofluoric acid compounds and related products may be found in certain refrigerants, anti-rust chemicals, fluorescent light bulbs, and glass etching compounds

Note: The compound can interact with other prescribed or non-prescribed medications in the body. Such interactions may enhance the therapeutic effects of other medications being taken, resulting in undesired side effects.

What are the Signs and Symptoms of Hydrofluoric Acid Poisoning?

The signs and symptoms of Hydrofluoric Acid Poisoning can vary from one individual to another. It may be mild in some and severe in others. Several systems of the body, such as the digestive system, respiratory system, vascular system, nervous system, skin and ENT may be affected.

The signs and symptoms of Hydrofluoric Acid Poisoning on contact with the skin or eyes may include:

• Severe skin burns; the skin may turn pale
• Blister formation
• Vision abnormalities including loss of vision
• Severe pain

The signs and symptoms of Hydrofluoric Acid Poisoning on inhalation of the vapors may include:

• Bluish discoloration of lips and beneath fingernails
• Respiratory difficulties; coughing and choking
• Tightness and pain in the chest
• Fever and chills
• Feeling weak and dizzy

The signs and symptoms of Hydrofluoric Acid Poisoning on ingestion of the chemical may include:

• Severe burning and associated pain in the mouth, throat, and food-pipe; drooling from the mouth
• Nausea, vomiting (blood in vomit may be seen)
• Stomach and abdominal pain that may be severe and cramping
• Chest pain
• Irregular heart-rate
• Collapse

How is First Aid administered for Hydrofluoric Acid Poisoning?

First Aid tips for Hydrofluoric Acid Poisoning:

• Call 911 or your local emergency help number immediately, for emergency assistance
• Call the Poison Control Center at 1-800-222-1222 (or your local poison control center) for further instructions
• Provide them with information such as the compound taken, quantity and time of ingestion, age, weight and general health status of affected individual
• Carefully remove the individual from the exposure area
• Confirm that the airways are protected; also, ensure breathing and the presence of pulse
• If skin exposure or involvement of the eye has occurred, then wash thoroughly with copious amounts of water (for at least 15 minutes)
• Unless instructed by a healthcare professional, DO NOT induce vomiting in the affected individual
• Take individual to emergency room (ER) for further treatment
• Always try to take the compound bottle/container to the ER

The emergency medical health professional might perform the following steps towards treating the condition:

• Monitor vital signs
• Medically manage symptoms, such as abnormal heart rate and seizures. Provide breathing support, if necessary
• In case of substance inhalation, special devices are used to deliver calcium into the lungs, to treat the symptoms
• If the substance is swallowed, then a solution of magnesium and calcium to counter the effects of the ingested chemical is administered. If on skin, the same solution is applied to the affected skin region
• Wash skin and eyes repeatedly and thoroughly (irrigation), to eliminate any remaining hazardous compound
• Following this, a suitable skin or eye ointment may be used to treat the exposure
• Surgical procedures to repair damaged areas and restore tissue and skin
• Administer fluids by an intravenous drip line

Who should administer First Aid for Hydrofluoric Acid Poisoning?

First aid for Hydrofluoric Acid Poisoning is administered by healthcare professionals.

• The individual who is affected, or someone near, should call 911 for emergency assistance (or the local emergency number)
• They should also call the poison control center at 1-800-222-1222 (or the local poison control center) and follow instructions

What is the Prognosis of Hydrofluoric Acid Poisoning?

• The prognosis of Hydrofluoric Acid Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient
• If the poisoning is mild, and if the individual can recover from the symptoms, with appropriate medication and early support, the outcome is generally good
• In many cases, skin burns may be extensive and very painful, such that permanent scarring is observed. Also, if the nerve endings on skin are affected, it may lead to loss of sensation around the burns. Eye injuries may be severe and loss of vision may be permanent
• In case of severe symptoms including severe burns, abnormal heart rates, seizures, and coma, it may considerably worsen the outcome
• Ingesting hydrofluoric acid can result in long-term damage to the mouth and food-pipe; the chemical has the potential to continue causing damage to the affected region, even after exposure is ceased. Perforations along the gastrointestinal tract is possible and it can result in severe complications including internal bleeding and infection. Such complications may lead to death

In general, toxicities are common situations in the emergency departments. A majority of the cases are often not fatal, when appropriate treatment is given.

How can Hydrofluoric Acid Poisoning be Prevented?

Hydrofluoric Acid Poisoning can be prevented by:

• Always following instructions for usage of any health or cosmetic products
• Keeping cosmetics, medications, and other healthcare products out of reach of children in child-proof containers
• Keeping any poisonous/hazardous chemicals and other materials out of children’s reach
• Keep all poisons correctly labeled and in suitable storage locations
• Using appropriate protective wear when working with such chemicals
• Being aware of basic first aid steps in case of an emergency (such as inadvertent poisoning)

What are certain Crucial Steps to be followed?

• Call 911 (or your local emergency number) for emergency assistance, if symptoms are life-threatening
• Call Poison Control Center at 1-800-222-1222 (or the local poison control center) and follow the recommend steps
• It would be helpful if the following information is readily available:
  • Type, amount and time of consumption of the substance
  • Age and weight of the individual
  • And, the overall health status of the individual