What is the treatment for acid exposure to the hands?

Treatment for Acid Exposure to Hands

For acid exposure to the hands, immediate and copious irrigation with water is the first-line treatment to dilute and remove the acid. 1

Immediate Management

First Aid

• Immediately irrigate the affected area with copious amounts of water for at least 15-20 minutes to dilute and remove the acid 1
• Use lukewarm or cool water rather than hot water to prevent additional skin barrier damage 2
• Pat dry hands gently rather than rubbing to avoid further irritation 2

Special Considerations for Hydrofluoric Acid

• Hydrofluoric acid burns require special attention as they can cause deep tissue damage and systemic effects 3, 4
• After initial water irrigation, apply calcium gluconate gel (2.5-5%) to the affected area to bind fluoride ions 4
• For severe hydrofluoric acid burns, consider calcium gluconate injections (subcutaneous or intra-arterial) under medical supervision 5
• Monitor for systemic effects including hypocalcemia, hypomagnesemia, and metabolic acidosis which can be life-threatening 6

Secondary Management

Assessment of Injury

• Evaluate the extent and depth of the chemical burn 4
• Check for signs of tissue necrosis, which may develop hours after the initial exposure 3
• For significant burns or pain that doesn't improve with initial treatment, seek immediate medical attention 4

Wound Care

• Apply moisturizer to undamaged skin around the affected area to maintain skin barrier function 2
• For minor burns after initial irrigation, apply a non-adherent dressing to protect the area 2
• Avoid applying gloves when hands are still wet from washing 2

Follow-up Care

Monitoring

• Watch for signs of infection (increased pain, redness, swelling, warmth, or discharge) 4
• Monitor for delayed tissue damage, which can occur 12-24 hours after exposure 3

When to Seek Advanced Medical Care

• Seek immediate medical attention for:
  • Extensive burns covering large areas of the hands 4
  • Deep burns or those involving the joints 4
  • Severe pain not relieved by initial treatment 5
  • Signs of systemic toxicity (for certain acids like hydrofluoric acid) 6
  • Changes in sensation or function of the hand 4

Prevention of Recurrence

Protective Measures

• Use appropriate protective gloves when handling acids 2
• Consider occupational modification if exposure occurred in a workplace setting 2
• For healthcare workers or those regularly exposed to chemicals, use water-based moisturizers under gloves 2

Common Pitfalls to Avoid

• Delaying irrigation after exposure 1
• Using neutralizing agents without medical direction, which can cause exothermic reactions and worsen tissue damage 4
• Failing to recognize the potential for systemic toxicity with certain acids (particularly hydrofluoric acid) 6
• Underestimating the severity of the burn, as tissue damage may progress over time 3