title: Hyperbaric oxygen therapy in the management of two cases of hydrogen sulfide toxicity from liquid manure.
abstract: 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.
authors.affiliation: Hyperbaric Medicine Service, Emergency Department, Hôtel Dieu de Lévis, Centre Hospitalier Affilié à l'Université Laval, Université Laval, Québec, Québec, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Belley
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bernard
authors.forename: Mario
authors.initials: M
authors.lastname: Côté
authors.forename: Francois
authors.initials: F
authors.lastname: Paquet
authors.forename: Julien
authors.initials: J
authors.lastname: Poitras