Hydrofluoric acid poisoning

Hydrofluoric acid

This acid is most commonly used for industrial purposes. It is used in:

• Computer screen manufacturing
• Fluorescent bulbs
• Glass etching
• High-octane gasoline manufacturing
• Some household rust removers

Note: This list may not be all inclusive.

From swallowing:

• Burns to the mouth and throat causing severe pain
• Drooling
• Breathing difficulty from throat and mouth swelling and burning
• Abdominal pain
• Vomiting blood
• Chest pain
• Collapse (from low blood pressure or shock)
• Irregular heartbeat

From breathing in (inhaling) the acid:

• Bluish lips and fingernails (cyanosis)
• Chills
• Chest tightness
• Choking
• Coughing blood
• Rapid pulse
• Dizziness
• Fever
• Weakness

If the poison touched your skin or eyes, you may have:

• Blisters
• Burns
• Pain
• Vision loss

Hydrofluoric acid poisoning can have direct effects on the heart. It can lead to irregular, and sometimes life-threatening, heartbeats.

People who come into contact with this poison are likely to have a combination of the listed symptoms.

Seek immediate medical help. DO NOT make a person throw up unless told to do so by poison control or a health care professional.

If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.

Immediately take the person to the hospital.

The following information is helpful for emergency assistance:

• The person's age, weight, and condition
• The name of the product (ingredients and strength, if known)
• The time it was swallowed
• The amount swallowed

However, DO NOT delay calling for help if this information is not immediately available.

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

Take the container with you to the hospital, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Swallowing this acid can cause a severe drop in blood pressure. If the person breathed in fumes from the acid, the provider may hear signs of fluid in the lungs when listening to the chest with a stethoscope.

Specific treatment depends on how the poisoning occurred. Symptoms will be treated as appropriate.

If the person swallowed the poison, treatment may include:

• Airway support, including oxygen, breathing tube through the mouth (intubation), and breathing machine (ventilator)
• Blood and urine tests
• Camera down the throat to see burns in the esophagus and the stomach (endoscopy)
• Chest x-ray
• CT (computerized axial tomography) scan
  
• ECG (electrocardiogram, or heart tracing)
• Fluids through a vein (IV)
• Magnesium and calcium solutions to neutralize the acid
• Medicines to treat symptoms

Note: Activated charcoal does not effectively treat poisoning by acids.

If the person touched the poison, treatment may include:

• Magnesium and calcium solutions applied to the skin to neutralize the acid (solutions may also be given through an IV)
• Monitoring to watch for signs of body-wide poisoning
• Medicines to treat symptoms
• Surgical removal of burned skin (debridement)
• Transfer to a hospital that specializes in burn care
• Washing of the skin (irrigation), possibly every few hours for several days

If the person breathed in the poison, treatment may include:

• Airway support, as noted above
• Breathing treatments that deliver calcium into the lungs
• Chest x-ray
• Camera down the throat to see burns in the airway (bronchoscopy)
• ECG (electrocardiogram, or heart tracing)
• Medicines to treat symptoms

How well a person does depends on the amount of poison swallowed and how quickly treatment was received. The faster a person gets medical help, the better the chance for recovery.

Hydrofluoric acid is especially dangerous. The most common accidents involving hydrofluoric acid cause severe burns on the skin and hands. The burns may be extremely painful. People will have a lot of scarring and some loss of function in the affected area.

The person may need to be admitted to a hospital to continue treatment. Swallowing this poison can have severe effects on many parts of the body. Extensive damage to the mouth, throat, and stomach are possible. Holes (perforations) in the esophagus and stomach may cause serious infections in the chest and abdominal cavities, which may result in death. Surgery may be needed to repair the perforations. Cancer of the esophagus is a high risk in people who live after ingesting hydrofluoric acid.

Fluorhydric acid

Hoyte C. Caustics. In: Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 143.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.