Aug. 18, 2003
John F. Sorrell, MD, FACEP, and Ralph M. Shealy, MD, FACEP
Medical Directors
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Use PPE to prevent exposure to acid.
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Remove to a non-contaminated environment.
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Rapidly decontaminate patient to prevent further absorption of acid and tissue destruction. Use copious flooding irrigation of exposed tissue.
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Establish intravenous access.
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Cardiac monitor. For cardiac irritability, prepare to administer calcium gluconate one amp IV while contacting Medical Control.
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For skin exposure:
Mix one amp calcium gluconate with KY jelly. Apply gel topically to burned skin. Leave gel in place. May reapply if pain recurs.
If topical treatment does not relieve pain, put one amp of calcium gluconate into 10 ml of normal saline to make a 5% solution. Using a 27-gauge needle, infiltrate 0.3-0.5 ml of the calcium solution into each square centimeter of burned tissue. May repeat if pain recurs. Use caution that volume of injected fluid does not compromise circulation when injecting into fingers.
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For inhalation exposure, put one amp of calcium gluconate into 30 ml of normal saline. Nebulize the 2.5% solution with oxygen.
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For eye exposure, put one amp of calcium gluconate into 90 ml of normal saline. Instill proparacaine anesthetic, then copiously irrigate with the 1% solution.
Note: One ampule of calcium gluconate is 10 ml of 10% solution, and contains one gram of calcium.
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