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Hydrogen fluoride (HF) – irritant gas used in chemical manufacturing Ca Gluconate – Initial ‐ 10 to 30 mL of 10% solution diluted in 150 mL 5% dextrose administered IV over 10 minutes Maintenance ‐ Add 100 mL 10% calcium gluconate to 900 mL of 5% dextrose and infuse at 50 mL/h (47 mg calcium ion). Titrate infusion rate against effect ‐ minimum infusion time is 4 to 6 h. Ingestion ‐ milk (one ‐ half to one glassful), chewable calcium carbonate tablets, or antacid for fluoride binding Dermal ‐ TOPICAL ‐ Treat with calcium gluconate or carbonate gel (1 g calcium gluconate in 40 g (about 40 mL) water ‐ soluble lubricant 15
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Folinic acid – enhance hepatic degradation of formate Furosemide – prevent renal absorption of formate 18
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40 days 32
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Aim of treatment: asymptomatic & COHb < 5% Hyperbaric O2 indication: 1) Unconcious 2) Neurological signs & symptoms 3) COHb > 25 % 4) Cardiac complication 35
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Hydroxocobalamin – 5g over 15 min infusion Sod. Nitrite – 10 ml of 3% sol IV Sod. Thiosulfate – 50 ml of 25 % sol. IV 44
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