MedBugs: SAQ #64

Case: Hydrofluoric acid

A 27-year-old male has presented to the Emergency Department complaining of severe pain in his right hand involving the palmar aspect, plus his thumb, index and middle fingers. He stated that he was cleaning the façade of a building 12 hours earlier and accidentally splashed his right hand with cleaning solution containing concentrated hydrofluoric acid (HF acid). He said that he was his hand with soap and water shortly after the incident occurred, under the direction of his supervisor. He is usually fit and well, takes no regular medication and is right hand dominant.

1. What are (2) potential features of topical exposure to hydrofluoric (HF) acid? 2 marks

2. Why are local anaesthetic techniques contraindicated for pain relief in HF acid injuries? 1 mark

3. List (2) most relevant investigations you would perform, with rationale. 4 marks

The patient received sufficient decontamina on pre-hospital and has now received appropriate doses of paracetamol and oxycodone. Despite this, he is still in severe pain.

4. What specific agent is the antidote for HF acid injury? 1 mark

5. Provide (4) ways in which this agent can be administered to treat HF acid injuries. 4 marks

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Case: Hydrofluoric acid

1. What are (2) potential features of topical exposure to hydrofluoric (HF) acid? 2 marks

2. Why are local anaesthetic techniques contraindicated for pain relief in HF acid injuries? 1 mark

3. List (2) most relevant investigations you would perform, with rationale. 4 marks

4. What specific agent is the antidote for HF acid injury? 1 mark

5. Provide (4) ways in which this agent can be administered to treat HF acid injuries. 4 marks

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