Hydrofluoric Acid Burns Follow-up

Updated: Mar 07, 2016
  • Author: Garry Wilkes, MBBS, FACEM; Chief Editor: Joe Alcock, MD, MS  more...
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Follow-up

Further Outpatient Care

Patients are suitable for discharge only when pain has been controlled adequately. Patients with serious exposures can be discharged once electrolytes return to normal, arrhythmias are absent, and ECG is normal, provided other complications are managed adequately.

Patients with finger burns can be discharged with calcium gluconate gel on the affected digits. Instruct patients to keep affected digits in a latex glove for 24 hours to maximize gel penetration.

Prudence requires physicians to provide follow-up care with all patients after 24 hours, at least by telephone.

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Further Inpatient Care

Admission to a burn service or ICU may be required if burns are extensive or if any clinical, laboratory, or electrocardiographic evidence of complications is present.

Animal models show promising results using growth factors as part of initial treatment for skin burns beyond chelation therapy. [4]

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Deterrence/Prevention

Most burns are a result of inadequate use of safety devices. Patient education is important to prevent recurrences.

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Complications

Complications are as follows:

  • Airway compromise
  • Systemic fluorosis
  • Acute lung injury/noncardiogenic pulmonary edema
  • Electrolyte abnormalities
  • Arrhythmias and cardiac arrest
  • Scarring
  • Loss of digits
  • Blindness
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Prognosis

Prognosis varies depending on burn severity and site. Poor prognosis follows fluoride inhalation.

Local effects of hydrofluoric acid burns include tissue destruction and necrosis. Burns may involve underlying bone. Systemic fluoride ion poisoning from severe burns may be associated with hypocalcemia, hyperkalemia, hypomagnesemia, and sudden death. Deaths have been reported from concentrated acid burns to as little as 2.5% BSA.

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