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Hyperbaric oxygen therapy in the management of two cases of hydrogen sulfide toxicity from liquid manure

Published online by Cambridge University Press:  21 May 2015

Richard Belley ,
Nicolas Bernard ,
Mario Côté ,
Francois Paquet  and
Julien Poitras
Richard Belley*
Affiliation:
Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l’Université Laval, Université Laval, Québec, Que.
Nicolas Bernard
Affiliation:
Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l’Université Laval, Université Laval, Québec, Que.
Mario Côté
Affiliation:
Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l’Université Laval, Université Laval, Québec, Que.
Francois Paquet
Affiliation:
Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l’Université Laval, Université Laval, Québec, Que.
Julien Poitras
Affiliation:
Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l’Université Laval, Université Laval, Québec, Que.
*
Emergency Department and Hyperbaric Facility, Centre Hospitalier Affilié de l’Hôtel Dieu de Lévis, 143 rue Wolfe, Lévis QC G6V3Z1

Abstract

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Hydrogen sulfide is a potent lethal gas. Supportive care, nitrite therapy and hyperbaric oxygen are the treatment modalities reported in the literature in cases of hydrogen sulfide exposure. We describe an industrial exposure in which 6 workers inhaled high concentrations of hydrogen sulfide when they entered a closed spreader tank partially filled with liquid swine manure. Five of the 6 lost consciousness, and 2 were agitated and poorly responsive on arrival to the emergency department despite having already received high-flow oxygen for nearly 1 hour. These 2 patients received nitrite therapy followed by orotracheal intubation and hyperbaric oxygen. All patients were discharged home without sequelae after short stays in hospital. The emergency management of hydrogen sulfide exposure is briefly reviewed.

Keywords

hyperbaric oxygen therapyhydrogen sulfideliquid swine manurenitrite therapy
Type
Toxicology • Toxicologie
Information
Canadian Journal of Emergency Medicine , Volume 7 , Issue 4 , July 2005 , pp. 257 - 261
Copyright
Copyright © Canadian Association of Emergency Physicians 2005

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