Emergency Treatment for Acid Exposure
Immediate skin decontamination with running water for at least 15 minutes is the recommended first-line treatment for acid exposure. 1, 2, 3
Initial Management Steps
- Remove all contaminated clothing, jewelry, and other materials from the affected area to prevent chemicals from being trapped against the skin 1, 3
- Brush off any dry chemical powder before irrigation with water 1, 3
- Irrigate the affected area with copious amounts of running water for at least 15 minutes 1, 2, 3
- Call emergency medical services (EMS) when a person with chemical exposure has respiratory symptoms, systemic symptoms, or large chemical exposures 1, 2
- Contact a regional poison control center for specific recommendations based on the chemical agent 1, 2, 3
Special Considerations for Specific Acids
- Hydrofluoric acid requires special treatment beyond water irrigation, as it can cause profound hypocalcemia and hypomagnesemia leading to potentially fatal outcomes 3, 4
- Certain chemicals like phenol also require decontamination with substances other than water 1, 3
- Battery acid (sulfuric acid) ingestion can cause severe gastrointestinal injury requiring surgical intervention 5
- Acetic acid ingestion can lead to hemolysis requiring plasma separation and exchange transfusion in severe cases 6
Treatment Based on Exposure Route
Skin Exposure
- Immediate decontamination with running water for at least 15 minutes is critical 1, 2, 3
- Patients who received immediate irrigation within 10 minutes with a large volume of water for at least 15 minutes had decreased degree of full-thickness burns, fewer full-thickness burns, and shorter hospital stays 1
Eye Exposure
- Flush eyes exposed to acids with large amounts of water unless a specific antidote is available 2
- Continue irrigation until pain is relieved 3
Ingestion
- Do not induce vomiting as this can cause additional damage 2, 7
- Do not give anything by mouth unless advised by a poison center or emergency medical personnel 2
- There is insufficient evidence to support dilution with water or milk as a first-aid measure 2
- Patients with significant acid ingestion may require endoscopic evaluation and possibly surgical intervention 1, 7
When to Seek Immediate Medical Attention
- Burns with blisters or broken skin 3
- Difficulty breathing or respiratory symptoms 1, 3
- Burns to the face, hands, feet, or genitals 3
- Partial-thickness burns covering more than 10% of body surface area (or more than 5% in children) 3
- Full-thickness burns 3
- Infected or very painful burns 3
- Signs of systemic toxicity (acidosis, electrolyte abnormalities) 4, 6
Common Pitfalls to Avoid
- Applying ice directly to burns can cause additional tissue damage 3
- Applying butter, oil, or other home remedies to burns is not recommended 3
- Delaying medical attention for significant burns 3
- Breaking blisters increases infection risk 3
- Failing to recognize systemic toxicity from certain acids (like hydrofluoric acid) which can be rapidly fatal 4, 8
- Underestimating the severity of acid burns, which can progress over 24-48 hours 1