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:

>           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.


Donít 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** 

Jean & Ken Smith wrote:
> Hi All,
> I just had the question posed to me Ė 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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