Carbon Disulfide

CAS RN:75-15-0

Treatment Overview

0.4.2 ORAL EXPOSURE
  • A) MANAGEMENT OF MILD TO MODERATE TOXICITY
    • 1) Dermal irritation should be treated with irrigation and supportive measures for dermatitis. Headaches can be treated with fresh air and analgesics.
  • B) MANAGEMENT OF SEVERE TOXICITY
    • 1) Management is similar as with any CNS depressant. Ensure airway is protected. If altered mental status and/or inability to protect airway, intubate and mechanically ventilate. Support volume status with intravenous fluids if cardiovascular collapse occurs. Use benzodiazepines for seizures.
  • C) DECONTAMINATION
    • 1) PREHOSPITAL: Wash topical exposures with water. Pre-hospital gastrointestinal decontamination is not recommended due to the potential for decreased mental status or seizures and subsequent aspiration.
    • 2) HOSPITAL: With large ingestions, administer activated charcoal if patient is alert and can protect airway or is intubated.
  • D) AIRWAY MANAGEMENT
    • 1) Endotracheal intubation and mechanical ventilation may be needed if CNS depression, seizures, or respiratory distress develop.
  • E) ANTIDOTE
    • 1) None
  • F) ENHANCED ELIMINATION
    • 1) There is no role for hemodialysis or other methods of enhanced elimination.
  • G) PATIENT DISPOSITION
    • 1) HOME CRITERIA: Asymptomatic patients with minor dermal or inhalation exposures can be monitored at home.
    • 2) OBSERVATION CRITERIA: Any symptomatic patient, those with deliberate exposure, and any patient who ingests carbon disulfide should be sent to a healthcare facility for evaluation and treatment.
    • 3) ADMISSION CRITERIA: Patients with large exposures, persistent or severe symptoms should be admitted for further care.
    • 4) CONSULT CRITERIA: Consult a medical toxicologist or poison center in large and/or symptomatic exposures.
  • H) PITFALLS
    • 1) Lack of decontamination, not recognizing as a potential exposure in someone who works with carbon disulfide, and not monitoring exposure in work place environment.
  • I) TOXICOKINETICS
    • 1) Carbon disulfide is highly volatile, so it is primarily rapidly absorbed via inhalation. Rapid absorption is also expected with ingestion. Dermal absorption is also reported. The majority of carbon disulfide is metabolized; 5% to 30% is excreted unchanged by the lungs, and trace amounts (0.05%) by the kidney.
  • J) DIFFERENTIAL DIAGNOSIS
    • 1) CNS depressants; other common solvents, such as hydrocarbons; other agents that can cause parkinsonism, such as carbon monoxide, MPTP.
0.4.3 INHALATION EXPOSURE
  • A) INHALATION: Move patient to fresh air. Monitor for respiratory distress. If cough or difficulty breathing develops, evaluate for respiratory tract irritation, bronchitis, or pneumonitis. Administer oxygen and assist ventilation as required. Treat bronchospasm with an inhaled beta2-adrenergic agonist. Consider systemic corticosteroids in patients with significant bronchospasm.
0.4.4 EYE EXPOSURE
  • A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.
0.4.5 DERMAL EXPOSURE
  • A) OVERVIEW
    • 1) DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).
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Find more information on this substance at: Hazardous Substances Data Bank , TOXMAP , TOXNET , PubMed