氫氟酸灼傷病患之急診照護經驗

The Nursing Care Experience for a Patient with Hydrofluoric Acid Burns in the Emergency Department

氫氟酸（Hydrofluoric acid）是一種非極性、高脂溶性、酸性且具腐蝕性無機化合物，被廣泛地使用在各種工業中，一旦暴觸會快速損傷深部組織而危害生命。本文旨在描述一位清潔人員工作時因戴棉質手套致使皮膚遭受氫氟酸二度灼傷的急診照護經驗。照護期間自2014年2月6日12:39至7日13:30，筆者運用Gordon十一項健康功能型態進行整體性評估，以會談、觀察等方式收集資料，結果個案出現電解質不平衡、皮膚完整性受損、急性疼痛、和焦慮等健康問題。在個案一入急診室立即給予氫氟酸灼傷的緊急處置，依個案疼痛程度及灼傷皮膚進展調整葡萄糖酸鈣劑量與頻率，成功阻止氫氟酸深入組織及擴散，並有效維持電解質平衡和緩解疼痛。且在個案焦慮至極狀況下，筆者予即時說明、陪伴及傾聽，緩解其對氫氟酸灼傷的焦慮，順利協助個案渡過急性期危機。期望藉由此罕見氫氟酸灼傷個案的急診護理經驗，能作為醫護同儕照護此類案例的參考。

Hydrofluoric acid (HF) is a non-polar, highly fat-soluble, and acidic inorganic compound with corrosiveness that is widely used in a variety of industries. The consequence of exposing to it would rapidly damage the deep tissue and therefore life-threatening. This article was to describe the experience of emergency care for a house keeping man exposing to hydrofluoric acid due to the fact that he was wearing cotton gloves, and led to a second degree hydrofluoric acid burn on his hands. During the care period from 12:39, February 6to 13:30, February 7 in 2014, the Gordon 11 Function Health Patterns was used to conduct holistic assessment and to collect patient's health problems by interview and observation. Those health problems included electrolytes imbalance, impaired skin integrity, acute pain, and anxiety. In ER, he was received the prompt treatment of HF poisoning based on pain severity and the progressive damaged. As a result, the procedure prevented further spread of the acid while effectively maintained electrolyte balance and alleviated the pain severity. Meanwhile, the authors provided immediate explanation, listened to and accompanied him to relieve the patient's anxiety and concern about hydrofluoric acid burns. The patient successfully overcame the acute phase crisis with the help of the treatment. It is hoped that the experience of emergency care for this rare case of hydrofluoric acid burn could be a reference for other colleagues.