{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:15:34Z","timestamp":1773162934939,"version":"3.50.1"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"7-8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,22]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>We report the case of a 37-year-old man presenting with pain out of proportion to the exam with hydrofluoric acid burns to his upper extremities after he spilled a wheel-stripping compound on his forearms while working at his powder coating business. His burns initially appeared mild and superficial, but over the course of several days, these evolved from simple erythema to significant partial thickness tissue destruction and ulceration. He required substantial topical, intradermal, and intravenous therapies to control the unseen burning process during his index visit to the emergency department. We transferred the patient to a burn center given the location of his burns and the causative agent. The burn center clinicians observed him over the course of two nights and then discharged him with instructions to come for multiple follow-up visits during the subsequent month. Following nonoperative management, he had an uneventful recovery with full function retained in the affected extremities. Hydrofluoric acid burns require prompt treatment with calcium to neutralize the burning process, despite a potentially benign initial appearance. The emergency clinician should use an aggressive diagnostic and therapeutic approach to patients presenting with pain out of proportion to their exam, as this finding is associated with various serious underlying pathology.<\/jats:p>","DOI":"10.1093\/milmed\/usac179","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T11:21:32Z","timestamp":1656069692000},"page":"e2793-e2796","source":"Crossref","is-referenced-by-count":2,"title":["Hydrofluoric Acid, an Unexpected Surprise"],"prefix":"10.1093","volume":"188","author":[{"given":"Colleen","family":"Meaney","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Carl R. Darnall Army Medical Center , Fort Hood, TX 76544, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Perdue","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Carl R. Darnall Army Medical Center , Fort Hood, TX 76544, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Umar","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Carl R. Darnall Army Medical Center , Fort Hood, TX 76544, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6312-2350","authenticated-orcid":false,"given":"Jerimiah","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Carl R. Darnall Army Medical Center , Fort Hood, TX 76544, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"key":"2023072301100718800_R1","first-page":"381","article-title":"Hydrogen fluoride--the protoplasmic poison","volume":"10","author":"Makarovsky","year":"2008","journal-title":"Isr Med Assoc J"},{"key":"2023072301100718800_R2","volume-title":"Tintinalli\u2019s Emergency Medicine: A Comprehensive Study Guide","author":"Tintinalli","year":"2016"},{"issue":"3","key":"2023072301100718800_R3","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.burns.2011.09.014","article-title":"Chemical burns \u2013 an historical comparison and review of the literature","volume":"38","author":"Hardwicke","year":"2012","journal-title":"Burns"},{"issue":"1","key":"2023072301100718800_R4","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.forsciint.2005.12.008","article-title":"Pathological demonstration of rapid involvement into the subcutaneous tissue in a case of fatal hydrofluoric acid burns","volume":"167","author":"Ohtani","year":"2007","journal-title":"Forensic Sci Int"},{"issue":"6","key":"2023072301100718800_R5","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1097\/BCR.0b013e31818b9de6","article-title":"Hydrofluoric acid burns: a 15-year experience","volume":"29","author":"Stuke","year":"2008","journal-title":"J Burn Care Res"},{"issue":"2","key":"2023072301100718800_R6","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1177\/229255031402200202","article-title":"A review of hydrofluoric acid burn management","volume":"22","author":"McKee","year":"2014","journal-title":"Plast Surg"},{"issue":"8","key":"2023072301100718800_R7","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/j.burns.2014.04.009","article-title":"A review of treatment strategies for hydrofluoric acid burns: current status and future prospects","volume":"40","author":"Wang","year":"2014","journal-title":"Burns"},{"issue":"1","key":"2023072301100718800_R8","doi-asserted-by":"crossref","first-page":"108","DOI":"10.7205\/MILMED-D-11-00165","article-title":"Hydrogen fluoride inhalation injury because of a fire suppression system","volume":"177","author":"Zierold","year":"2012","journal-title":"Mil Med"},{"issue":"1","key":"2023072301100718800_R9","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1177\/0897190011420677","article-title":"Emergency management of chemical weapons injuries","volume":"25","author":"Anderson","year":"2012","journal-title":"J Pharm Pract"},{"key":"2023072301100718800_R10","article-title":"The Maryland Poison Center\u2019s monthly update: news, advances, information","volume-title":"Maryland Poison Center","author":"Booze"},{"issue":"5","key":"2023072301100718800_R11","first-page":"931","article-title":"Hydrofluoric acid burns of the hand","volume":"52","author":"Dibbell","year":"1970","journal-title":"J Bone"},{"issue":"5","key":"2023072301100718800_R12","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/S0196-0644(97)70076-3","article-title":"Regional intravenous infusion of calcium gluconate for hydrofluoric acid burns of the upper extremity","volume":"30","author":"Graudins","year":"1997","journal-title":"Ann Emerg Med"},{"issue":"2","key":"2023072301100718800_R13","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.burns.2003.09.031","article-title":"Hydrofluoric acid burns","volume":"30","author":"Hatzifotis","year":"2004","journal-title":"Burns"},{"key":"2023072301100718800_R14","article-title":"Burn center referral criteria","author":"American Burn Association"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/7-8\/e2793\/50936933\/usac179.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/7-8\/e2793\/50936933\/usac179.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T01:14:15Z","timestamp":1690074855000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/188\/7-8\/e2793\/6617310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,24]]},"references-count":14,"journal-issue":{"issue":"7-8","published-online":{"date-parts":[[2022,6,24]]},"published-print":{"date-parts":[[2023,7,22]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usac179","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7,1]]},"published":{"date-parts":[[2022,6,24]]}}}