Sodium Hydrosulfide

CAS RN:16721-80-5

Laboratory

A) Obtain a complete blood count in symptomatic patients following an alkaline corrosive ingestion.
B) In patients with signs and symptoms suggesting severe burns, perforation, or bleeding (or adults with deliberate, high volume or high concentration ingestions), obtain renal function tests, serum electrolytes, INR, PTT, type and crossmatch for blood, and monitor urine output. Serum lactate and base deficit may also be useful in these patients.
C) Monitor pulse oximetry or arterial blood gases in patients with signs and symptoms suggestive of upper airway edema or burns.
D) Obtain an upright chest x-ray in patients with signs and symptoms suggesting severe burns, perforation, or bleeding (or adults with deliberate, high volume or high concentration ingestions) to evaluate for pneumomediastinum or free air under the diaphragm. The absence of these findings DOES NOT rule out the possibility of necrosis or perforation of the esophagus or stomach. Obtain a chest radiograph in patients with pulmonary signs or symptoms.
E) Several weeks after ingestion, barium contrast radiographs of the upper GI tract are useful in patients who sustained grade II or III burns, to evaluate for strictures.
A) Specific laboratory studies for confirming hydrogen sulfide exposure are not readily available in most clinical laboratories and are often not clinically useful.
B) Monitor serum electrolytes, BUN, creatinine, glucose, CBC, CPK, urinalysis, and ECG.
C) Monitor vital signs, pulse oximetry and/or arterial blood gases and chest radiograph in patients with respiratory signs or symptoms.
D) In the acutely ill patient, blood gas analysis may demonstrate metabolic acidosis, and elevated mixed venous oxygen measurement. Lactate is also usually elevated.
E) Hydrogen sulfide can also be measured in the environment by many emergency response teams using electrochemical sensors.
F) Brain CT may reveal white matter demyelination and degeneration of the globus pallidus in patients with severe poisoning.
G) Monitor methemoglobin levels if nitrite antidotes are administered.
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