Treatment and Management of H2S Poisoning

Immediate and appropriate handling of the situation is essential for the survival from H2S exposure. There are two categories for treatment and management: Pre-hospital Care and Emergency Department Care.

Pre-Hospital Care

Site of Exposure 

Pre-hospital responders must have complete knowledge and have gone through training before trying to assist any of the victims. Always come prepared with proper equipment that cover the skin, eyes, and have a respiratory device before entering the site of exposure. If the pre-hospital responder is not equipped in handling the situation, it is best to call for a HAZMAT team who have proper equipment such as the self-contained breathing apparatus (SCBA).

Check Airway, Breathing, Circulation (ABCs)

  • Check if the victim is able to breathe with a proper airway
  • Check for the pulse and if the chest rises
  • Assess whether the patient has the ability to be carried off; if the victim is suspected of an injury sustained from exposure, ensure proper care for mobilization such as a neck brace and a spinal stretcher to be used to carry the victim out of the site of exposure

Safe Zone

Carefully assess which victim requires the most immediate medical attention. Not all victims will have the same amount of exposure; it is best to know which to prioritize for it is essential for survival.

 Check Airway, Breathing, Circulation (ABCs)

  • Check for the victim’s ability to breathe and whether the airway in sufficient for proper oxygenation in the lungs
  • Check for the pulse and the chest rise
  • Apply a breathing apparatus like a bag-valve mask

Decontamination

Requires the personnel to be equipped with protective equipment for secondary contamination is highly probable.

  • Carefully remove the clothing of the victim and place in a marked sealed container
  • Carefully wash the victim with water to help rinse off the chemical
  • Since direct exposure to the liquefied gas can cause frostbite, determine whether the patient has frostbite – if so, carefully apply blankets to the affected area to help warm the exposed area encourage circulation

Wait for advanced trained medical personnel for help

Emergency Department Care

Medical personnel are at a low risk from being contaminated by H2S if the victim was mildly exposed to the H2S gas. However if the victim was heavily exposed and the clothing of the victim were not rid of prior to arriving in the hospital, medical personnel are at high risk of contamination. Treatment in the hospital mostly involves treating the respiratory and cardiovascular system. Continuous monitoring by medical personnel and a follow up post-care is essential.

Different Types of Treatment

Here are the different types of treatment that are administered depending on the level of exposure and which system is most affected:

Pulmonary (by inhalation of H2S gas)

  • Administering 100% oxygen ventilation through the use of a mask
  • Aerosolized bronchodilators for symptoms of bronchospasms

–          Aerosol: a spray of the medicine

–          Bronchodilators: it opens up the airways by relaxing the smooth muscles that surround the airways

–          Bronchospasms: is when the smooth muscles surrounding the airways (bronchial tubes) are tight which make it difficult to breathe; this results in a wheezing noise when breathing

  • In severe compromised victims, administering the victim into hyperbaric oxygen therapy

–          Hyperbaric oxygen therapy: the patient is exposed to 100% oxygen within a pressurised chamber

Cardiovascular

  • IV fluids and vasopressors are used to treat victims with abnormal low blood pressure (hypotensive)

–          Vasopressor: a type of drug (depending on the ingredients) that constrict the smooth muscles that make up the blood vessels, reducing the circumference of the blood vessels causing an increase in blood pressure

Skin

  • H2S gas does not get absor
  • bed through the skin – but if skin suffered frostbite from direct exposure to liquefied gas, medical personnel will treat it like a thermal burn
  • Carefully treated with warm water and blankets

Eyes

  • Washing or flushing out the irritated eyes with water (irrigation)

Other Treatments – Nitrate Therapy

  • Amyl nitrate is introduced into the victim
  • Amyl nitrate is used to relax blood vessels and increasing the supply of blood and oxygen
  • Helps rid of excess sulfide in the tissues

For more information visit: http://www.atsdr.cdc.gov/substances/toxsubstance.asp?toxid=67

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