H2S gas poisoning

[PiBond]

---

Members don't see this ad.

I was curious if anyone had ever come across H2S poisoning in their emergency department. Of the gasomodulators, I get the impression that it's fairly rare but I was hoping to get an answer straight from the horse's mouth.

I have a modest understanding of its pathophysiology (inhibition of ETC via cytochrome c oxidase binding) but I was curious on how an ER doc would pick up on the specific gas type poisoning if a person was brought in unconscious. If they were known to work at a petroleum plant would this type of poisoning be your first guess? Or would the metabolic acidosis be a better indicator?

I'm entering medical school in the next year and have done a good amount of research in geriatric emergency medicine, and thus ER has become a real point of interest to me.

Any input is much appreciated.

 

[Rendar5]

It would need a high degree of suspicion and the situation report from the paramedics bring the patient in. Perhaps a strong smell of rotten eggs would be a clue. Anything else would need a strong degree of luck. like having blacked coins in the patient's hand.

 

[NateintheED]

We saw a couple of H2S patients when I was a med student. One guy was overcome, then the second guy went in to try and pull the first guy out. Nasty poisoning.

As far as knowing it was H2S, I agree that circumstances as reported by medics or others are key. The situation that immediately comes to my mind is sewer gas.

 

[docB]

Unless I have a really reliable history I'm probably not going to start trying to find the sodium nitrite (if we even have any). It'll be decon and supportive care as usual.