33 yo M presents with pain in left hand after being exposed to industrial cleaning product at work. Patient sates he feels a great amount of pain at the site and tingling radiating from the site. In the emergency room, he starts to have palpitations. He subsequently goes into ventricular fib. Patient is coded. What is a potential source of symptoms? Is there a reversible cause.
The patient has symptoms that might make us concerned about hydrofluoric acid exposure. Some indurstrial cleaning products contain the chemical. They are typically used to remove blemishes from stainless steel, such as grafetti from the side of subway cars. It is also used in glass etching.
HF readily dissolves through skin. Once in circulation, the chemical binds up avaialable calcium and magnesium stores. The serum calcium can drop to near undetectable levels. The patient is then prone to cardiac arrythmias and death. Patients require significant calcium infusions. Magnesium repleation may be required as well. Well not considered standard of care, case report exsist of improved outcome with emergent dialysis.