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Burns
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
Hydrofluoric acid will continue to injure until the fluorine is chelated. Extreme pain is the hallmark as nerves are irritated. Neuropathic pain is common for months afterwards. After washing the area, the next step is to introduce cations to the injury front. Ca++ and Mg++ are used. Techniques include: Calcium added to gel and applied topically.Calcium gluconate solution added to dimethyl sulfoxide (DMSO) and especially useful for soaking fingertips.Intra-arterial infusion of calcium.Bier's block with calcium gluconate.Hypocalcaemia can result from small areas burned with concentrations >10%. The amount of calcium that may need to be intravenously infused is staggering. Beware!
Medical Management of Chemical Warfare Agents
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
There are few antidotes available for HazMat/chemical weapons medical care. When you have identified a toxidrome with an antidote, it is important to start that antidote as quickly as possible to prevent worsening and to reverse the clinical syndrome (Table 30.5). This is especially true of organophosphate/nerve agent and cyanide poisoning, as these toxins can have irreversible effects on the human organism. Use oxygen liberally to reverse any hypoxic state. It will also reverse carbon monoxide poisoning but much more slowly than the preferred hyperbaric oxygen therapy. Another hemoglobin asphyxiant, methemoglobinemia, has methylene blue as an antidote. Cyanide, a cellular asphyxiant, requires three substances to reverse its toxicity. These are amyl nitrite (not used by the military due to difficulty with controlling the dose), sodium nitrite, and sodium thiosulfate. Another option is a vitamin B12 precursor, hydroxocobalamin (CYANOKIT®). For organophosphate/carbamate and nerve agent poisonings, immediate agents to use are atropine, pralidoxime (2-PAM Cl), and a benzodiazepine such as midazolam. There are a couple of other antidotes for syndromes not mentioned earlier. Hydrofluoric acid exposure requires calcium gel and intravenous calcium chloride to stop the pain and damage. The anticholinergic syndrome caused by hydrazine requires pyridoxine for treatment. Details on some of these antidotes are located earlier in the chapter.
Burns
Published in Ian Greaves, Keith Porter, Chris Wright, Trauma Care Pre-Hospital Manual, 2018
Ian Greaves, Keith Porter, Chris Wright
Hydrofluoric acid is a common chemical used in glass etching and in the manufacture of printed circuit boards. Exposure to even 1% TBSA can be fatal due the systemic effects of fluoride ions, dependent upon the concentration strength. Calcium gluconate can be used to neutralise the acid and prevent continued injury.
The powder in the basement: how an unlabeled poison inspired federal legislative change
Published in Clinical Toxicology, 2022
Keahi M. Horowitz, Robert G. Hendrickson, Adam Blumenberg
After absorption, however, the mechanism of toxicity for NaF is unclear, but is presumed to be similar to that of other rapidly-dissociating fluoride compounds (for example, hydrofluoric acid (HF)). Fluoride may directly or indirectly impair enzymatic activity, resulting in cellular apoptosis, acidemia, and significant disruption of cellular metabolism – similar to presentation of poisoning by other metabolic toxins [28]. Rat experiments, case reports, and postmortem studies of such fluoride exposures suggest that the common pathophysiology is profound hypocalcemia and hypomagnesemia with widespread cellular dysfunction [26]. Biochemical studies suggest that the formation of fluorapatite enhances calcium binding at a rate greater than the body’s compensatory homeostatic mechanisms resulting in profound hypocalcemia [26]. In some cases, serum calcium concentrations have been as low as 6.5 mg/dL in an adult and 3.4 mg/dL in a child [27,29]. Membrane destabilization due to the low calcium and magnesium concentrations may manifest as muscular excitability, including tetany, diaphragmatic irritability, and cardiac dysrhythmias [3,27,29]. Patients may even rapidly progress to life-threatening ventricular dysrhythmias and respiratory arrest [3,27,29].
Influence of resin cement on color stability of ceramic veneers: in vitro study
Published in Biomaterial Investigations in Dentistry, 2021
Maryam Hoorizad, Sara Valizadeh, Haleh Heshmat, Seyedeh Farnaz Tabatabaei, Tahereh Shakeri
In groups 4 and 5, resin cements were bonded to the ceramic surface. For this purpose, the ceramic surface was prepared according to the manufacturer’s instructions. First, 5% hydrofluoric acid (Bisco Inc., Schaumburg, IL) was applied on the unglazed ceramic surface for 20 s and was then rinsed and dried for 1 min. The two components of silane (Bis-Silane; Bisco Inc., Schaumburg, IL) were mixed and applied on the surface of ceramic disc and dried for 30 s. Unfilled resin (Heliobond; Ivoclar Vivadent AG, Schaan, Lichtenstein) was applied on the silanized ceramic surface. Treated ceramic disc was placed in a Teflon mold with 0.8 mm height and 10 mm diameter and resin cement was then applied over it similar to the clinical procedure. The cement surface was covered with a Mylar strip and a glass slab and a 2.5 kg weight was placed over it for 20 s in order to obtain a uniform thickness of cement [10]. After removing the weight, the samples were cured through the ceramic disc at four points for 60 s using a LED light-curing unit (Demetron LC; Kerr, Orange, CA) with a measured intensity of 500 mW/cm2via ceramic discs by the overlapping technique. The light intensity was measured using a radiometer (Kerr Corporation, Orange, CA).
Fate of GdF3 nanoparticles-loaded PEGylated carbon capsules inside mice model: a step toward clinical application
Published in Nanotoxicology, 2020
Binapani Mahaling, Madhu Verma, Gargi Mishra, Surabhi Chaudhuri, Debjani Dutta, Sri Sivakumar
Tetraethyl orthosilicate (TEOS), n-octadecyltrimethoxysilane (C-18 TMS), gadolinium nitrate hexahydrate (Gd(NO3)3·6H2O), bis-amino polyethylene glycol (PEG) (6000 kDa), trypsin-EDTA, Dulbecco’s-modified eagle’s medium (DMEM), penicillin–streptomycin antibiotic, N3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), phosphate buffer saline (PBS), gelatin (from cold water fish skin), and Gadolinium (Gd) standard were purchased from Sigma-Aldrich. Sulfuric acid (H2SO4), nitric acid (HNO3), ethanol, triton X-100, dimethylformamide (DMF), and dimethyl sulfoxide (DMSO) were obtained from Merck Chemicals, India. Hydrofluoric acid (HF), and sodium fluoride (NaF) were obtained from SD. Fine Chem. Ltd, India. Ammonium fluoride (NH4F), ethylenediaminetetraacetic acid (EDTA), and oleic acid were obtained from Loba Chemie, India. Sodium chloride (NaCl), sodium hydroxide (NaOH), methanol, hydrogen peroxide (H2O2) (30% w/v in water), and aqueous ammonia (25% v/v) were purchased from Fisher Scientific. Cell ROX-Alexafluor-488 reagent and Annexin-V-Alexafluor-488 reagent were purchased from Thermo Fisher Scientific. All the above chemicals were used as received. HeLa, NIH3T3, NRK-49F, MCF-7, HepG2 and PC3 cell lines were purchased from National Center for Cell Science, Pune, India.