Hydrogen sulfide toxicity

Background

1. Colorless, flammable gas w/ rotten egg odor
2. Encountered in oil/gas industries, natural product of decomposition (e.g. septic tank)
3. Mechanism of toxicity is similar to CN (disruption of aerobic metabolism)

Clinical Features

1. One of the few chemical asphyxiants that also possesses irritative properities
   1. Respiratory, ocular irritation
2. High conc exposure may result in LOC, seizure, and death after only a few breaths
   1. Delayed pulm edema and corneal destruction should be anticipated w/ massive exposures

Treatment

1. Decontamination of skin/eyes
2. O2 100% NRB
3. Consider giving nitrite component of CN kit (do not give thiosulfate portion)
   1. Low level MetHb may enhance conversion of sulfide to less toxic sulfmethemoglobin