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Table 2 Specific progression comments of HFEPs corresponding to ED disposition subgroups

From: Lessons learned from reviewing a hospital’s disaster response to the hydrofluoric acid leak in Gumi city in 2012

ED disposition

Specific progression comment of HFEPs

Discharge

None specified

DAMA

Five patients in the DAMA subgroup in the acute phase comprised three factory workers and two news reporters. They received calcium gluconate nebulizer treatment for their dyspnea symptoms; ADM to the hospital was recommended, but they refused. Only one worker later visited the outpatient ophthalmology department.

Death

Two patients died in the acute phase, and had been diagnosed with complex injury (>  2) due to a combination of chemical intoxication and burns. One was dead upon arrival at the ED and the other was alive upon ED arrival but had severe hypocalcemia (blood calcium level, 3 mg/dL; normal adult range, 8.6–10.2 mg/dL) and recurrent refractory ventricular dysrhythmia. The patient died despite > 1 h of advanced cardiovascular life support, including calcium gluconate administration.

ADM

One patient was admitted to the hospital after visiting the ED with chief complaint of vomiting on October 6, 2012 after HF exposure, and was diagnosed with gastric ulcer. However, there were no definitive data in terms of criteria for ADM upon chart review.

  1. ADM Admission, HF Hydrogen fluoride, Acute phase First 8 h after onset of HF leak, Subacute phase 24 h after acute phase, Chronic phase 22-day period after acute and subacute phases, DAMA Discharge against medical advice, ED Emergency department, HFEPs Hydrogen fluoride-exposed patients