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PLASMACHEM-L  September 2011

PLASMACHEM-L September 2011

Subject:

Re: Treatment for HF exposure

From:

Michael Shelley <[log in to unmask]>

Reply-To:

PLASMACHEM-L: Analytical Chem.(ICP's, DCP's, MIP's).

Date:

Wed, 21 Sep 2011 10:46:57 +1000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (109 lines)

Mike,

	This paper mentions using iced solutions for treatment, so 
maybe cold rather than warm water?:
http://occmed.oxfordjournals.org/content/46/4/313.full.pdf

This one talks of ice packs to relieve pain and retard diffusion of 
the fluoride ion:
http://emedicine.medscape.com/article/773304-treatment

On the other hand, this one talks of irrigation with copious 
quantities of luke-warm water, the authors regularly treat HF burns 
and show images, very comprehensive and if I was still working with 
HF I'd keep a copy to take with me to hospital.
http://www.belsurg.org/uploaded_pdfs/103/103_375_378.pdf

There does seem to be a distinct difference of opinion between those 
who follow the quick wash/immediate application of calcium gluconate 
model, and those with the wash for as long as possible model. MSDS's 
have a standard paragraph specifying rinsing for 15 minutes, so may 
not be a realistic guide. Perhaps if the gel was immediately 
available, the quick wash/gel treatment would be appropriate, 
otherwise keep rinsing? I did try rinsing with cold tap water on one 
occasion and it was so painful after a few minutes that  anyone who 
could bear it for 15 minutes has my admiration - obviously it would 
depend on how cold the water.

There is a quick reference chart:
http://ehs.unc.edu/ih/lab/docs/hfaexposure.pdf


Experiments to determine the best treatment:
http://www.ncbi.nlm.nih.gov/pubmed/17091088

There is a huge literature, and it now seems that benzalkonium 
chloride may be preferred to calcium gluconate as a topical 
treatment. How an anti-bacterial was found to be effective is not 
obvious to me, perhaps someone can explain that?

Sometimes when I read of medical treatments they bring to mind 
Charles II, he who apologized to his doctors (who were competing with 
each other to dream up even more bizarre treatments) for being so 
long dying... Medicine is still an experimental "science".

	Mike Shelley


>Steve,
>
>What you write about flush time makes sense.
>
>I still want to know flush with warm or cold water???
>
>
>Michael M. Cheatham
>
>
>
>On 9/20/11 5:57 PM, "Pappas, Richard Steve (CDC/ONDIEH/NCEH)"
><[log in to unmask]> wrote:
>
>>Excellent comments from Glenn and Mike.
>>The one final comment I would add before going home for the day regards
>>rinse time after exposure. Most MSDSs say flush with water 15 to 30
>>minutes. That is a standard comment for any acid exposure. HF is
>>different, Whereas with a nitric or hydrochloric or sulfuric acid
>>exposure, the damage is mainly at the surface, HF crosses membranes, as
>>has been discussed. Flushing for 15 minutes will not do much more than
>>flushing for 15 seconds if you got it all rinsed off in 15 seconds. For a
>>huge exposure, strip the clothes and run for the emergency shower for
>>sure - forget all modesty. The clothes only serve to keep the diluted
>>acid against the skin for more absorption. After rinsing away the
>>superficial exposure, the next most important thing is to attempt to
>>limit penetration. That is where calcium gluconate gel comes in. The
>>thought is that if you use it quickly enough, you might get enough rubbed
>>in to tie up excess fluoride diffusing into skin before it goes too deep,
>>and diminish the absorption. 15 minutes rinsing is overkill that will
>>cost you time while the HF that has already diffused below the dermal
>  >surface continues to penetrate further.
>>You get the superficial HF off, then start addressing the epidermally
>>absorbed portion with calcium before it becomes the basal cell-absorbed
>>or circulation-distributed portion.
>>Merry crystals to all
>>And to all a Good night.
>>
>>R. Steven Pappas, Ph.D.
>>Smoke Analysis Group
>>Centers for Disease Control & Prevention
>>4770 Buford Hwy, M.S. F-44
>>Atlanta, GA USA 30341-3717
>>770-488-4661
>  >[log in to unmask]
>>

-- 



	Michael Shelley,  Director
	Laurin Technic Pty. Ltd.
	59 McIntyre St.
	Narrabundah
	Australian Capital Territory 2604
	Australia
	Ph   +61 2 62952551
	email: [log in to unmask]

@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!@!

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