Dear Paul (et al)
Sorry, but rubbing in creams is wrong first aid. Prolonged washing to rapidly dilute & remove acid on the surface is the most vital initial treatment. Topical applications of chemicals to precipitate the fluoride ion is a 2y response. If systemic calcium is necessary, then this should be by local injection, not ingestion.
-----Original Message-----
From: Paul Richardson [mailto:[log in to unmask]]
Sent: Mon 21/06/2004 20:00
To: [log in to unmask]
Cc:
Subject: Re: Hexafluorine vs Calcium Gluconate in the treatment of HF burns
Hi,
HF acid, as I remember back to working in a large oil refinery on the
Red Sea coast of Saudi, is really not nice stuff and definatley not
something one can take lightly. The first aid procedure I recall is
that the cream is rubbed into the burn (if =>2.5cm)for 15 minutes after
intial contact with skin. Anything bigger than that needed calcium
chewable tablets(name escapes me) or IV. The fact that the refinery
produced gallons of the stuff as a by product of the refining process,
and location of the refinery meant that one had to have these protocols
in place.
Regards
Paul
"Swann, Alan B" <[log in to unmask]> wrote on 21.06.2004, 13:52:12:
> There is a extremely good review just published in the journal Burns
>
> Burns. 2004 Jun;30(4):391-8.
>
> Instructive reading, explaining why HF burns behave oddly (e.g. little surface effect but major deeper effects upsetting electrolyte balance) & some cautionary tales (death from severe electrolyte imbalance in a 2.5% surface area burn!)
>
> I'd recommend as compulsory reading for anyone who has HF burns as a hazard on their manor.
>
> The review emphasises that irrigation is the first line Rx. Other chemical treatments follow this.
> It rates the efficacy of Hexafluorine & topical Calcium Gluconate as good, but insufficient information available on Hexafluorine o side effects to compare against other efficacious treatments.
>
> For very small burns, as is the usual in university laboratories, you should also consider water as 1st line treatment. Always rapidly available, plentiful supply & always in-date. If pain relief is achieved, then the problem is solved & 2nd line treatment may be unnecessary.
>
> This may be a situation like with cyanide poisoning, where antidotes are not made available in labs, to ensure that the essential 1st line low-tech treatment is not by-passed in the rush to use the sacred antidote.
>
> Aileen,
>
> Thanks for posting this. It has provoked me into looking at the evidence & consider reviewing our practice!
>
> Dr. Alan Swann, BM, AFOM
> Director of Occupational Health
> Occupational Health Service
> Imperial College London
> Southside building
> South Kensington Campus
> London
> SW7 2AZ
> Tel: +44 (20) 7594 9385
> Fax: +44 (20) 7594 9407
> http://www.imperial.ac.uk/hq/occhealth/
> https://www.imperial.ac.uk/spectrum/occhealth (Intranet)
>
> -----Original Message-----
> From: Higher Education Occupational Physicians [mailto:[log in to unmask]] On Behalf Of Aileen Stewart
> Sent: 21 June 2004 10:47
> To: [log in to unmask]
> Subject: Hexafluorine vs Calcium Gluconate in the treatment of HF burns
>
> I am wondering if anyone might have current articles or information
> evidencing the use of hexafluorine vs. calcium gluconate for skin or
> ophthalmic exposures to hydrofluoric acid. I've been asked by one of our
> labs about changing to hexafluorine but can't find much UK data to back this
> up. Hex fluorine appears to be widely used as the treatment of choice in
> Europe and the USA but I'd be grateful for any current UK thinking on this.
> Regards
> Aileen
>
>
> Aileen Stewart
> University Of Glasgow
> Occupational Health Manager
> Tel (Direct) 0141 330 8069
>
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--
Paul G Richardson BA RGN OND
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