MedBugs: SAQ #609

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Case: Chemical Hand Injury

A 27-year-old right-hand-dominant male presents with severe pain in his right hand after splashing concentrated hydrofluoric acid cleaning solution onto the palmar aspect of his hand, thumb, index and middle fingers 12 hours earlier.

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

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

3. List the most relevant investigations you would perform, with rationale. 4 marks

The patient received sufficient decontamination 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 hydrofluoric acid injury? 1 mark

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

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