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EXTRACT FROM:

http://www.who.int/water_sanitation_health/GDWQ/Chemicals/hydrsulfidefull.ht

m#humans

...When inhaled, hydrogen sulfide is highly acutely toxic to humans (25). Its

rapid mode of action involves the formation of a complex with the iron(III)

ion of the mitochondrial metalloenzyme cytochrome oxidase, thereby blocking

oxidative metabolism (4,25). Other enzymes reported to be inhibited by

sulfides are succinate dehydrogenase, adenosinetriphosphatase, DOPA oxidase,

carbonic anhydrase, dipeptidase, benzamidase, and some enzymes containing

iron such as catalase and peroxidases (1). Reduction of disulfide bridges in

proteins has been suggested as a mechanism whereby enzyme function could be

altered (3). Irritation of the eyes and respiratory tract can be observed at

concentrations of 15-30 mg/m3, and concentrations of 700-1400 mg/m3 can

cause unconciousness and respiratory paralysis resulting in death (3).

Nigel

-----Original Message-----

From: tom5255 [mailto:tom5255@...]

Hi all,

having a disagreement on the mech of action of H2S when it kills you!

Any thoughts

Cheers

Tom

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Hi Tom,

it is a long time since I worked in a refinery, but if I remember correctly;

H2S is a colourless gas, with a smell of rotten aggs at low concentrations.

It has an affinity for water, dissolving in the fluid of the upper airways

to cause intense burning and irritation. It also causes lacrimation,

photophobia.

In high concentrations (you can't smell it - which is why it is so

dangerous.)

At this level it causes paralysis of the respiratory centre.........

OwenD

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Wow, a bit more complex explanation than mine...

OwenD

> EXTRACT FROM:

>

>

http://www.who.int/water_sanitation_health/GDWQ/Chemicals/hydrsulfidefull.ht

> m#humans

>

>

> ..When inhaled, hydrogen sulfide is highly acutely toxic to humans (25).

Its

> rapid mode of action involves the formation of a complex with the

iron(III)

> ion of the mitochondrial metalloenzyme cytochrome oxidase, thereby

blocking

> oxidative metabolism (4,25). Other enzymes reported to be inhibited by

> sulfides are succinate dehydrogenase, adenosinetriphosphatase, DOPA

oxidase,

> carbonic anhydrase, dipeptidase, benzamidase, and some enzymes containing

> iron such as catalase and peroxidases (1). Reduction of disulfide bridges

in

> proteins has been suggested as a mechanism whereby enzyme function could

be

> altered (3). Irritation of the eyes and respiratory tract can be observed

at

> concentrations of 15-30 mg/m3, and concentrations of 700-1400 mg/m3 can

> cause unconciousness and respiratory paralysis resulting in death (3).

>

> Nigel

>

>

>

> -----Original Message-----

> From: tom5255 [mailto:tom5255@...]

>

> Hi all,

> having a disagreement on the mech of action of H2S when it kills you!

> Any thoughts

>

> Cheers

>

> Tom

>

>

>

>

> Member Information:

>

> List owner: Ian Sharpe Owner@...

> Editor: Ross Boardman Editor@...

>

> Post message: egroups

> Subscribe: -subscribeegroups

> Unsubscribe: -unsubscribeegroups

>

> Thank you for supporting Remote Medics Online.

>

>

>

>

>

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Guest guest

Hi Tom

What is the nature of your disagreament .....

Tony M

tom5255 <tom5255@...> wrote: Hi all,

having a disagreement on the mech of action of H2S when it kills you!

Any thoughts

Cheers

Tom

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Guest guest

The main point was wether H2S blocked 02 transfer by replacing oxygen with

Iron III or wether it interupted the electrial transmissons from the brain

teeling you to breath. Nigel forwarded a nice article which proved my point!

Cheers

Tom

>From: Tony M <gold_wing_uk@...>

>Reply-

>

>Subject: Re: h2s

>Date: Wed, 26 Jun 2002 02:51:16 -0700 (PDT)

>

>

>Hi Tom

>What is the nature of your disagreament .....

>Tony M

> tom5255 <tom5255@...> wrote: Hi all,

>having a disagreement on the mech of action of H2S when it kills you!

>Any thoughts

>

>Cheers

>

>Tom

>

>

>

>

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  • 6 years later...

Hi Chaps,

I've followed the discussion regarding H2S, I worked for 5 years in a

field that had up to and beyond 40k ppm H2S in the production system

an wells. All personnel lived with their BA escape set in their

pockes!

At the end of the day it does not make much of a difference what is

happining metabolically nor knowing the indepth pathology and

relating it to SpO2 readings unles you know some basic facts; signs

and symptoms and importantly the level of the H2S ppm hit.

The symptoms that are presenting and the understanding or knowing if

the patient has had a previous history of H2S exposure, does / did

smoke and any other cardio-vascular / RTI's or pulmonary dissorder

which can and does reduce his / her resistance to the effects of H2S.

This is where it is import to have a handle on the personnal

occupation healt monitoring such as " well man / well woman "

programmes.

0.13ppm - Min preceptable smell - little effect

4.60ppm - Easily detectable with moderate smell - little effect -

most personal gas detectors will alarm at 5ppm and personnel evacuate

area protocols area observed

10ppm - Sence of smell may go but not always the case - begining of

eye irritation

27ppm - Strong smell - tolerable to some - eyes start to stream

100ppm - Coughing, eyes streaming, total loss of smell two minute plus

200-300ppm - Marked eye inflammation & Resp Tract irritation

500+ppm - Loss of consciousness, stopping / pausing of respiration &

death if not remove from area to safe clean are - less that 3 minutes

exposure

700+ppm - Rapid loss of consciousness, stopping / pausing of

respiration leading death - brain damage almost certain - exposure

time measured in seconds

1000+ppm - Unconscious on immediate exposure, respiration stopped

within seconds, death - even removal to fresh air will not help to

aid in a good outcome, at best ALS protocol and anti-toxic protocols

will only end in permanent brain damage with successful resuscitation

2000+ppm - Instant death

Sabre International & Total Safety in the UK can give you supporting

guidence and information, Aberdeen Royal Infirmary have set protocols

on H2S treatment or for that matter any toxic gasses, Prof. Graham

Page or any of the medical staff are up to date on treatments.

I'm not been pedantic but sometimes the basics are more important

than the indepth science and without having blood gas analysis etc

treat the symptoms in front of you (this is the way of thinking

within hyperbaric medicine which is another one of my specialties), I

hope this has helped the discussion and hope you get the information

you need.

Rgds,

Donnie

>

>

> Dear All,

>

> Monitoring Spo2 will not add any things to your management of H2S

poisoning, because already you know the pathophy of H2S and I would

rather concentrate on treatment which maily is O2 and some cases

hyperbaric chambers and as well symptomatic treatment as follows:

>

> 1.Decontamination:

>

>

> Patient without skin or eye irritation they do not need

decontamination, they have to be transferred directly to the AMP

> Ø Eye:

> - Do Not irrigate frostbitten eyes.

> - Eye irritation: Irrigate with NS water for 5min

> Ø Skin:

> - Frostbitten skin: cover the affected part gently in

blanket(Warm) encourage the victim to exercise the affected part.

> - Exposed skin: flush with water for 5min

>

> 2.Medical treatment:

>

>

>

> ØBLS protocol + O2 high concentration 15 l/min + + +

> Ø Monitor + IV line + glucose solution 5%

> Ø For patient with bronchospasm:

> - If victim responsive treat with aerosolized bronchodilators :

> • Bricanyl monodoses 5mg/2ml NS (2-6hrs action)

> • Methylprednisolone 1mg/kg iv slow.

> - If unconscious treat with:

> • Bricanyl monodose subcutaneous 3microgram

> • Methylprednisolone 1mg/kg iv slow.

> Ø Some patient develop pulmonary edema :

> • 40 mg of Furosemide IV

> and trigger your medevac to the nearest and appropriate medical

facility and think about hyperbar chambre if the casualty has

neurologic disorders.

>

> Regards

>

> Dr:Zehari

>

> @...: w.mackie@...: Mon, 12 Jan 2009

11:08:10 -0700Subject: Re: H2S

>

>

>

> Et all;The patho and chemists in the group have made me also go

back to the books, the good doctor is right on track in explanation,

thanks for the review. I would like to add that there is a

possibility of generating methemoglinemia to a greater degree from

exposure, of H2S than generating sulfhemoglobin, from my readings but

exactly how ... still reading. The problem is we have not answered

the original query so yes methhemoglobin and sulfhemoglobin will

affect SpO2 readings, in the typical pulse Oximeter, one would need

ABGs and a co-oximeter to get accurate numbers, although

sulfhemoglobin levels are said to be not useful in treatment of H2S

poisoning. Now for giggles have many seen the new RAD 57 ?

http://www.masimo.com/rad-57/They are flying off the shelves here as

we now CAN read carboxyhemoglobin levels now in the field .. that

said the regular pulse ox is quite impudent on CO poisonings, I think

most of us would be down to supportive care in most cases either H2S

or CO.cheersWilf

H2SDoes anybody know if hydrogen sulfide will

bind to the hemaglobin andcrowd out O2? In essence, I'm wondering if

a pulse ox reading is semireliable in an H2S exposure or it it can

just be scrapped like incarbon monoxide exposures?Thanks!Jessie

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Wilf has produced an answer, nice work sir.

 

At the end of the day, SpO2 readings deserve very little credit as an

independent diagnostic tool in my book. If the pt is awake, their complaint,

lung assessment and respiratory effort dictate my path.

 

The pulse ox earns its keep by being helpful in monitoring trends when serial

blood gasses aren't possible (which is most of the time).

 

So if I'm around H2S and I smell a rotten egg fart, I will beat feet to the

infirmary and demand the RAD 57!

 

Peace,

 

Guy

From: Wilf Mackie <w.mackie@...>

Subject: Re: H2S

Date: Monday, January 12, 2009, 1:08 PM

Et all;

The patho and chemists in the group have made me also go back to the books, the

good doctor is right on track in explanation, thanks for the review. I would

like to add that there is a possibility of generating methemoglinemia to a

greater degree from exposure, of H2S than generating sulfhemoglobin, from my

readings but exactly how ... still reading.

The problem is we have not answered the original query so yes methhemoglobin and

sulfhemoglobin will affect SpO2 readings, in the typical pulse Oximeter, one

would need ABGs and a co-oximeter to get accurate numbers, although

sulfhemoglobin levels are said to be not useful in treatment of H2S poisoning.

Now for giggles have many seen the new RAD 57 ?

http://www.masimo. com/rad-57/

They are flying off the shelves here as we now CAN read carboxyhemoglobin levels

now in the field .. that said the regular pulse ox is quite impudent on CO

poisonings, I think most of us would be down to supportive care in most cases

either H2S or CO.

cheers

Wilf

[Remotemedics. co.uk] H2S

Does anybody know if hydrogen sulfide will bind to the hemaglobin andcrowd out

O2? In essence, I'm wondering if a pulse ox reading is semireliable in an H2S

exposure or it it can just be scrapped like incarbon monoxide exposures?Thanks!

Jessie

____________ _________ _________ _________ _________ _________ _

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Lancez-vous !

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Oh I agree and I thank everybody for their answers. We had a false alarm last

week and everybody " involved " was absolutely complaint free. It just left me

with the scenario running through my head and occurred to me that I had no idea

if an SpO2 reading would have ANY validity whatsoever if there were real

patients in this case. Just one of those things that I was simply curious about

since I was afforded the time to ponder it.

Jessie

----- " Guy " <guyser1975@...> wrote:

|

|

|

|

Wilf has produced an answer, nice work sir.

|

| At the end of the day, SpO2 readings deserve very little credit as an

independent diagnostic tool in my book. If the pt is awake, their complaint,

lung assessment and respiratory effort dictate my path.

|

| The pulse ox earns its keep by being helpful in monitoring trends when serial

blood gasses aren't possible (which is most of the time).

|

| So if I'm around H2S and I smell a rotten egg fart, I will beat feet to the

infirmary and demand the RAD 57!

|

| Peace,

|

| Guy

|

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Jessie,

Where are you working?

myself I am working in the midlle east we have 42% H2S .

regards

Dr:Zehari

@...: medicjess@...: Tue, 13

Jan 2009 19:46:43 +0000Subject: Re: H2S

Oh I agree and I thank everybody for their answers. We had a false alarm last

week and everybody " involved " was absolutely complaint free. It just left me

with the scenario running through my head and occurred to me that I had no idea

if an SpO2 reading would have ANY validity whatsoever if there were real

patients in this case. Just one of those things that I was simply curious about

since I was afforded the time to ponder it. Jessie ----- " Guy "

<guyser1975@...> wrote: | | | | Wilf has produced an answer, nice work

sir. | | At the end of the day, SpO2 readings deserve very little credit as an

independent diagnostic tool in my book. If the pt is awake, their complaint,

lung assessment and respiratory effort dictate my path. | | The pulse ox earns

its keep by being helpful in monitoring trends when serial blood gasses aren't

possible (which is most of the time). | | So if I'm around H2S and I smell a

rotten egg fart, I will beat feet to the infirmary and demand the RAD 57! | |

Peace, | | Guy |

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I'm onshore in the US in an area that has a " few " spots with H2S. We don't

actually have any live production, primarily research right now.

Jessie

----- " O C " <slbdoctor@...> wrote:

|

|

|

|

| Jessie,

|

| Where are you working?

|

| myself I am working in the midlle east we have 42% H2S .

|

| regards

|

| Dr:Zehari

|

| @... : medicjess@... : Tue,

13 Jan 2009 19:46:43 +0000Subject: Re: H2S

|

| Oh I agree and I thank everybody for their answers. We had a false alarm last

week and everybody " involved " was absolutely complaint free. It just left me

with the scenario running through my head and occurred to me that I had no idea

if an SpO2 reading would have ANY validity whatsoever if there were real

patients in this case. Just one of those things that I was simply curious about

since I was afforded the time to ponder it. Jessie ----- " Guy " <

guyser1975@... > wrote: | | | | Wilf has produced an answer, nice work

sir. | | At the end of the day, SpO2 readings deserve very little credit as an

independent diagnostic tool in my book. If the pt is awake, their complaint,

lung assessment and respiratory effort dictate my path. | | The pulse ox earns

its keep by being helpful in monitoring trends when serial blood gasses aren't

possible (which is most of the time). | | So if I'm around H2S and I smell a

rotten egg fart, I will beat feet to the infirmary and demand the RAD 57! | |

Peace, | | Guy |

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Hi ,

Sabre International & Total Safety in the UK can give you supporting

guidence and information, Aberdeen Royal Infirmary have set protocols

on H2S treatment or for that matter any toxic gasses, Prof. Graham

Page or any of the medical staff are up to date on treatments.

I'll get contact details for regarding courses you and mail out

accordingly, in the mean time I need your direct mail to send you the

protocols that have.

Rgds,

Donnie

>

> Hiya Guys,

>

> With all this talk of H2S, does anyone know of any

H2S

> awareness courses run in the UK,

>

>

>

>

>

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It makes me so happy to see SP02 taking little credit in this post,

it deserves very little credit indeed

| | | | Wilf has produced an answer, nice

work sir. | | At the end of the day, SpO2 readings deserve very

little credit as an independent diagnostic tool in my book. If the pt

is awake, their complaint, lung assessment and respiratory effort

dictate my path. | | The pulse ox earns its keep by being helpful in

monitoring trends when serial blood gasses aren't possible (which is

most of the time). | | So if I'm around H2S and I smell a rotten egg

fart, I will beat feet to the infirmary and demand the RAD 57! | |

Peace, | | Guy | [Non-text portions of this message have been

removed]

> |

> | __________________________________________________________

> | Sur Windows Live Ideas, découvrez en exclusivité de nouveaux

services en ligne... si nouveaux qu'ils ne sont pas encore sortis

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