Emergency Response Procedures:

The general first-aid procedure for acid burns is to flush the affected area with water for fifteen minutes. However, if a person is exposed to HF, the following first-aid is highly recommended.

Skin Exposure

Immediately washing off the acid is a priority!

1. Immediately wash all affected areas with water. While flushing with water be sure to remove all contaminated clothing or jewelry that could trap HF (remove goggles last, close eyes, face water flow and pull goggles over head).
2. While the victim is being rinsed with water, someone should call 911 and provide the dispatcher with the following information:
   1. There is a person that has been exposed to hydrofluoric acid.
   2. The location where the victim can be found.
   3. Please send an officer and ambulance.
3. Rinsing may be limited to 5 minutes if Calgonate is available. Apply the gel as soon as the washing is done. Affected area does not need to be dried prior to application. If Calgonate is not available, continue flushing with water until medical treatment has arrived.
4. Apply Calgonate freely and massage it into the affected site. Reapply Calgonate every 10-15 minutes, until pain and/or redness disappear or until emergency medical assistance is given.

   In order to prevent cross contamination, the victim should self-apply Calgonate. If the victim is unable to do so, anyone present can do it.  Be extremely careful not to contaminate yourself by using Neoprene or Nitrile (22mil)) gloves. Do not use latex gloves; they do not provide effective protection against HF acid burns.

   Note: Clinical experience has shown that Calcium Gluconate 2.5% Gel is effective when used correctly in appropriate situations.

5. After the treatment to the burned areas has begun, the victim should be examined to ensure no other burn sites have been overlooked.
6. Calgonate should be reapplied continuously every 10-15 minutes and massaged into the skin until the ambulance arrives and the victim is seen by a physician.
7. Take note of and provide the following information to the EMS team, and or physician.
   1. The concentration of the Hydrofluoric Acid and the MSDS sheet.
   2. Date and time of exposure. Duration of exposure, and how it occurred.
   3. The time when Calgonate was first applied to the contaminated area.
   4. Body parts affected or exposed, and the percent of body surface area affected.
   5. Summary of first aid measures given.

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Eye Exposure:

Because of the ability of HF to penetrate deep into tissue, exposure of HF solution or vapor to the eye can produce more extensive damage than that of other acids in similar concentrations. For example, hydrochloric acid damages only the superficial structures of the eye because its penetration is limited by a precipitated protein barrier. In the case of HF, immediate action should be taken with initial flushing, followed by treatment with sterile 1% calcium gluconate solution.

1. Immediately flush eyes for at least 5 minutes with cool flowing water. Hold the eyelids open and away from the eye during irrigation to allow thorough flushing of the eyes. If sterile 1% calcium gluconate solution is available, washing may be limited to 5 minutes, after which the 1% calcium gluconate solution should be used repeatedly to irrigate the eye using a syringe.
   
   
2. Immediately take the victim to a doctor, preferably an eye specialist. Ice water compresses may be applied to the eyes while transporting the victim.

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Inhalation:

If a large volume of hydrofluoric acid gas is inhaled:

1. Immediately move the victim to fresh air and get medical attention.
   
   
2. Keep victim warm, quiet, and comfortable.
   
   
3. If breathing has stopped, begin CPR at once. Make sure mouth and throat are free of foreign material.
   
   
4. 100% oxygen (10 to 12 L/min flow rate) should be administered as soon as possible by a trained individual. Continue oxygen while waiting for medical attention.
   
   
5. A nebulized solution of 2.5% calcium gluconate may be administered with oxygen by inhalation.
   
   
6. Do not give stimulants unless instructed to do so by a physician.
   
   
7. The victim should be examined by a doctor and held for observation for at least 24 hours. The reason is that inhalation of HF fumes may cause swelling in the respiratory tract up to 24 hours after exposure. A person who has inhaled HF vapors may require prophylactic oxygen treatment.
   
   
8. Vapor exposures can cause skin and mucous membrane burns as well as damage to pulmonary tissue. Vapor burns to the skin are treated the same way as liquid HF burns.

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Ingestion:

1. Have the victim drink large amounts of water as quickly as possible to dilute the acid. Do not induce vomiting. Do not give emetics (vomit inducing agents) or baking soda.
   
   Never give anything by mouth to an unconscious person.
   
   
2. Drink several glasses of milk or several ounces of Milk of Magnesia, Mylanta, Maalox or similar product, or eat up to 30 Tums, Caltrate or other antacid tablet. The calcium or magnesium in these compounds may act as an antidote.
   
   
3. Seek immediate medical attention.

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Literature references

Source: Segal, Eileen, B “First Aid for a Unique Acid, HF: A Sequel” Chemical Health and Safety, Jan/Feb 2000 vol. 7, #1, p18.

Bronstein, A. C. and Currance, P. L. “Emergency Care for Hazardous Materials Exposures” Mosby Company 1988.

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