Hydrofluoric acid ingestion should be managed with which action?

• A. Observation only
• B. Rapid transport
• C. Gastric lavage on arrival
• D. Activated charcoal

Answer: (B)

Hydrofluoric acid ingestion can cause serious systemic fluoride toxicity that binds calcium, leading to hypocalcemia and potentially dangerous heart rhythms. The priority is rapid transport to a facility where calcium-based antidotal therapy (such as IV calcium gluconate) can be started and the patient can be closely monitored and treated for electrolyte and cardiac issues. Gastric lavage isn’t appropriate because fluoride injuries can continue to cause damage, and it doesn’t address the systemic toxicity. Activated charcoal doesn’t effectively bind fluoride, so it won’t prevent complications. Observation alone risks missing rapid development of hypocalcemia and arrhythmias. In the field, focus on airway and breathing support, establish IV access, monitor the patient, and get them to definitive care as quickly as possible.