on 22/6/04 9:59 am, Tracie McKelvie at [log in to unmask]
wrote:
> I was led to believe that water would "feed" the acid and cause further
> damage???? and was taught to rub in the relevant cream.????
>
> Has the protocol changed?
>
> Tracie Mckelvie
> Occupational Health Nurse / Adviser
> Pembrokeshire College
> Merlins Bridge
> Haverfordwest
> Pembs.
> SA61 1SZ
>
> TEL: 01437 765247 Ext 393
> FAX: 01437 767279
> E-mail: [log in to unmask]
>
>
>>>> [log in to unmask] 06/22/04 09:41am >>>
> 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
>>
>> ~~~~~~~~~~~~~~~
>> Please remove this footer before replying.
>>
>> For list archives and documents, go to
>> http://www.jiscmail.ac.uk/lists/occ-health.html for list archives
>>
>> For jobs in Occupational Health, go to
>> http://uk.groups.yahoo.com/group/OHJobs/
> --
> Paul G Richardson BA RGN OND
>
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> "
Not sure what you mean by "feeding" an acid. Are you confusing this with
concentrated sulphuric acid. Water reacts violently with conc Sulphuric acid
when it is added to the acid but not the other way round. -Its all to do
with reducing the concentration. Even a conc sulphuric acid splash would be
treated initially with irrigation with copious amounts of water.
Alan is quite correct water is always the first treatment in order to
dilute/wash off the acid as quickly possible. Only when that treatment is
complete should calcium gluconate be applied.
Anne
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