REGIONAL INTRAVENOUS-INFUSION OF CALCIUM GLUCONATE FOR HYDROFLUORIC-ACID BURNS OF THE UPPER EXTREMITY

Study objective: To describe regional intravenous infusion of calcium gluconate as a therapy for hydrofluoric acid (HF) burns of the forearm , hand, or digits. Methods: This study describes seven patients with H F burns. Calcium gluconate, 10 mi of 10% solution with 30 to 40 mi nor mal saline solution, was injected intravenously into the affected limb using a Bier block technique. Ischemia was maintained for 20 to 25 mi nutes. Therapy was considered successful if significant reduction of p ain and tenderness was noted after tourniquet release. Results: Seven patients were treated. HF concentration varied from 5% to 49%. Exposur e sites included the forearm (two cases), thenar eminence and digits ( two cases), or digits only (three cases). Complete pain resolution occ urred on tourniquet release in four patients (two with burns to the fo rearm, two with burns to digits only). One patient had partial relief (thenar but not digital exposure site), and two had no relief of sympt oms. Intraarterial calcium gluconate perfusion was subsequently admini stered to the three patients with persistent subungual and pulp, or th enar pain. Recovery was complete in all cases. No adverse effects were noted. Conclusion: Regional intravenous infusion of calcium gluconate should be considered a therapeutic option in HF burns of the forearm, hand, or digits when topical therapy fails.