Management overview for hydrofluoric acid poisoning

Note: Urgently contact a clinical toxicologist or poisons information centre if hydrofluoric acid poisoning is suspected.

Hydrofluoric acid (also known as hydrogen fluoride) is used for glass etching, metal cleaning, electronics manufacturing and rust removal. Following exposure to hydrofluoric acid, clinical effects depend on the route of exposure and concentration of the solution.

Most hydrofluoric acid poisoning involves dermal exposure to a low-concentration solution that can cause severe pain and dermal injury.

If hydrofluoric acid is ingested, severe caustic injury can result—for management of acute caustic injuries, see the Caustic ingestions monograph.

Systemic fluorosis is a life-threatening complication that can occur after hydrofluoric acid ingestions and dermal or inhalational exposures. The risk of developing systemic fluorosis is higher if the exposure involves a high-concentration solution or a large body surface area.

The mainstays of treatment for hydrofluoric acid poisoning are:

intravenous calcium therapy for systemic fluorosis
regional calcium therapy for dermal injuries
nebulised calcium therapy for inhalational exposures
adequate analgesia
management of electrolyte disturbances and QT-interval prolongation.

Deliberate self-poisoning with hydrofluoric acid has a high mortality rate. If hydrofluoric acid poisoning is suspected, urgently contact a clinical toxicologist or poisons information centre (13 11 26).