Fatal Refractory Ventricular Fibrillation Due to Ingestion of Hydrofluoric Acid

Abstract

Hydrofluoric acid (HF) is a colorless and odorless solution of the hydrogen fluoride in water. It is used in some household products. The rapid onset of severe toxicity and death after the ingestion of HF is not reported often. Also, there is no reported fatal pediatric case after HF ingestion. In this case report, we present a 3.5-year-old girls who unintentionally drunk a rust remover that contained 8% HF. She died in a short period as a result of refractory ventricular fibrillation, which was developed due to fluoride intoxication.

Hydrofluoric Acid: Burns and Systemic Toxicity, Protective Measures, Immediate and Hospital Medical Treatment

“…The most frequent exposure is by cutaneous contact with the aqueous solution, no matter if the skin is intact or damaged [ 28 ], [ 29 ], [ 30 ], [ 31 ], [ 32 ]; it could also be absorbed through eyes [ 33 ], [ 34 ]. Inhalation intoxication occurs not only from exposure to hydrogen fluoride gas [ 17 ], [ 35 ], but also from vapors arising from concentrated hydrogen fluoride liquid [ 20 ], [ 36 ], while ingestion [ 14 ], [ 37 ], [ 11 ] of even a small amount of this acid is likely to produce systemic effects and may be fatal [ 13 ], [ 16 ], [ 18 ], [ 38 ], [ 39 ].…”

“…Special attention should be paid if intoxicated persons are children [ 13 ]. Because of their relatively larger surface area: body weight ratio, children are more vulnerable to the hydrofluoric acid absorbed through the skin.…”

“…In the dental industry and every-day clinical practice, HF acid is used as an etchant agent for ceramic materials [ 6 ], [ 7 ], [ 8 ]. Hydrofluoric acid can be found in consumer products for marble, brick and stone cleaning, as a rust removal, in automobile wheel cleaners, toilet bowl cleaners, air conditioners cleaners, and as insecticides [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ].…”

“…Unintentional exposure to hydrofluoric acid or gases, with health consequences, may occur in case of inappropriate operation, inadequate protection, when having machine problems, explosion of HF containers and tanks, during the traffic accidents [ 1 ], and inattentive usage of household agents [ 10 ], while intentionally, in case of suicide [ 11 ], [ 12 ], [ 14 ] and murder. There are cases of intoxicated children when domestic cleaners, in appropriately stored, were accidentally ingested [ 13 ].…”

“…The tissue damage and the degree of toxicity are determined by the acid concentration, the exposure time, the contaminated body surface area, the time elapsed between exposure and decontamination i.e. hospital care [ 21 ], [ 22 ], [ 23 ], and person’s age as well [ 13 ], [ 24 ].…”