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Subject: Re: H2S Antidotes
Date: Fri, 26 Mar 2010 17:36:16 -0700
Author: "Stephen W. Hemperly"
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Subject: Re: H2S Antidotes
Date: Fri, 26 Mar 2010 21:41:07 -0500
Author: "Cook, Ray"
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Date: Fri, 26 Mar 2010 21:09:26 -0400
Reply-To: DCHAS-L Discussion List <DCHAS-L**At_Symbol_Here**LIST.UVM.EDU>
Sender: DCHAS-L Discussion List <DCHAS-L**At_Symbol_Here**LIST.UVM.EDU>
From: "Samuella B. Sigmann" <sigmannsb**At_Symbol_Here**APPSTATE.EDU>
Subject: Re: H2S Antidotes
In-Reply-To: <003b01cacd3e$f5ece550$4101a8c0**At_Symbol_Here**smithrocket>
From Webwiser:
http://webwiser.nlm.nih.gov/getSubstanceData.do?substanceID=339&displaySubstanceName=Hydrogen%20Sulfide&UNNAID=&STCCID=&selectedDataMenuItemID=8
> 0.4.3 INHALATION EXPOSURE
>
> * A) IMMEDIATELY MOVE PATIENT TO FRESH AIR AND ADMINISTER 100
> PERCENT OXYGEN.
> o 1) PREVENT SELF-EXPOSURE and possible death by wearing a
> self-contained breathing apparatus to rescue the victim.
> * B) SEIZURES: Administer a benzodiazepine IV; DIAZEPAM (ADULT: 5
> to 10 mg, repeat every 10 to 15 min as needed. CHILD: 0.2 to 0.5
> mg/kg, repeat every 5 min as needed) or LORAZEPAM (ADULT: 2 to 4
> mg; CHILD: 0.05 to 0.1 mg/kg).
> o 1) Consider phenobarbital or propofol if seizures recur
> after diazepam 30 mg (adults) or 10 mg (children > 5 years).
> o 2) Monitor for hypotension, dysrhythmias, respiratory
> depression, and need for endotracheal intubation. Evaluate
> for hypoglycemia, electrolyte disturbances, hypoxia.
> * C) HYPOTENSION: Infuse 10 to 20 mL/kg isotonic fluid. If
> hypotension persists, administer dopamine (5 to 20 mcg/kg/min)
> or norepinephrine (ADULT: begin infusion at 0.5 to 1 mcg/min;
> CHILD: begin infusion at 0.1 mcg/kg/min); titrate to desired
> response.
> * D) NITRITE THERAPY - Amyl nitrite by inhalation and IV sodium
> nitrite (found in cyanide antidote kit) may be beneficial by
> forming sulfmethemoglobin, thus removing sulfide from
> combination in tissue. Do NOT use sodium thiosulfate. The
> antidotal efficacy of nitrite therapy is controversial; it
> should be considered in patients with severe symptoms who
> present soon after exposure.
> * E) ACUTE LUNG INJURY: Maintain ventilation and oxygenation and
> evaluate with frequent arterial blood gas or pulse oximetry
> monitoring.
>
Sammye
--
***************************************************************************************
Don’t always believe what you think.
Samuella B. Sigmann, NRCC-CHO
Lecturer/Safety Committee Chair
A. R. Smith Department of Chemistry
Appalachian State University
525 Rivers Street
Boone, NC 28608
Phone: 828 262 2755
Fax: 828 262 6558
Email: sigmannsb**At_Symbol_Here**appstate.edu
Jean & Ken Smith wrote:
>
> Hi All,
>
> I just had the question posed to me – does anyone know of an antidote
> to H2S exposure?. This is oil refinery related where a sudden exposure
> to H2S could happen if something goes wrong with compressors and other
> pipelines and machinery. If anyone has knowledge of an antidote,
> please let me know. I believe that this might have relevance in other
> places also.
>
> Ken Smith
>
> Retired CIH
>
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