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3810075 
Journal Article 
Review 
Prolonged hypocalcemia refractory to calcium gluconate after ammonium bifluoride ingestion in a pediatric patient 
Maddry, JK; Kester, A; Heard, K 
2017 
Yes 
American Journal of Emergency Medicine
ISSN: 0735-6757
EISSN: 1532-8171 
Elsevier Limited 
35 
2 
378.e1-378.e2 
English 
27609122 
MEDLINE:27609122 
 



In this case report, a 2-year-old girl ingested "a couple of fingers full" of Armor Etch glass etching cream (21%-27% ammonium bifluoride) and was taken to the emergency department after 5 episodes of vomiting within an hour of ingestion. Upon arrival to the emergency department (ED) 2 hours after the time of ingestion, the patient was no longer vomiting, and had normal vital signs, a normal physical examination, normal electrocardiogram finding, and an ionized calcium level of 1.21 mmol/L (reference range, 1.24-1.40 mmol/L). The patient did not have a history of vitamin D deficiency, renal failure, or the consumption of other xenobiotics known to cause hypokalemia. 
Vitamin D; Hands; Rodents; Poisons; Pediatrics; Calcium; Milk; Patients; Laboratories; Fluorides; Vomiting; Etching 
OPPT
• Gluconates
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