A Rare Toxic Agent in the Emergency Department: Sulphur Hexafluoride

Öz

Giriş: Sülfür hekzaflorid (SF-6 ) biyolojik açıdan etkisiz kabul edilmesine rağmen, akut maruziyetlerde oksijen ile yer değiştirerek asfiksi ve ölüme neden olabilir. SF-6 tıbbi cihazlardan uzay sanayisine kadar pek çok alanda kullanılmaktadır. Olgu Sunumu: On dokuz ve otuz iki yaşlarında iki elektrik işçisi, yüksek gerilimli elektriği kesmek için kullandıkları cihazın arıza yapması sonucu ortaya çıkan SF-6 adlı gaza yaklaşık 5-10 dakika maruz kalma ve takiben bulantı, kusma, baş dönmesi şikayetleri ile acil servisimize getirildi. Başvuru anında her iki hastanın da genel durumu iyi, bilinci açık ve vital bulguları stabil idi. Fizik muayene bulguları normal sınırlarda olan hastalar takip ve tedavi amaçlı acil gözlem ünitesine yatırıldı. Hastalar gözlem sürecinin ardından şifa ile taburcu edildi. Sonuç: Her ne kadar kimyasal ve biyolojik olarak zararsız olsa da SF-6 acil servislerde nadir görülen bir toksik ajan olup akut maruziyetlerde ölüm riski taşımaktadır. Bu nedenle hastaların ölümcül komplikasyonlar açısından gözlem altına alınması ve izlenmesi faydalı olacaktır.

Anahtar Kelimeler

• Sülfür hekzaflorid, intoksikasyon, acil servis

A Rare Toxic Agent in the Emergency Department: Sulphur Hexafluoride

Öz

Introduction: Although sulfur hexafluoride (SF-6) is considered biologically inert, it may cause asphyxia and death, replacing oxygen. SF-6 is used in many areas, varying from medical devices to the aerospace industry. Case Report: Two electricity workers, who were 19 and 32 years old, were admitted to our emergency deperatment with complaints of nausea, vomiting, and dizziness after SF-6 exposure of about 5-10 minutes because of malfunction of their high-voltage circuit breaker. At admission, the general condition and mental status of both patients were good. Their vital signs were stable. The patients, with normal physical examination findings, were hospitalized to the emergency observation unit for follow-up and treatment. Both patients were discharged after follow-up. Conclusion: Although it is considered chemically and biologically inert, a rare toxic agent in the emergency department, SF-6, has a risk of death in acute exposure. Monitoring and follow-up of these patients are necessary for reducing fatal complications

Anahtar Kelimeler

• Sulphur hexafluoride, intoxication, emergency service

Kaynakça

1. Burton DJ. Using the NIOSH Pocket Guide to Chemical Hazards. Occup Health Saf 2001; 70: 20-22.
2. NIOSH; NOES. National Occupational Exposure Survey conducted from 1981-1983. Estimated numbers of employees potentially exposed to specific agents by 2-digit standard industrial classification (SIC). Avai- lable at http://www.cdc.gov/noes/ as of Feb 15, 2007.
3. Macklem PT. The physiology of small airways. Am J Respir Crit Care Med 1998; 157: 181-3. [CrossRef]
4. Wong IY, Wong D. Special Adjuncts to Treatment. In Stephen Ryan, MD, Editor. Retina. 5th ed. Elsevier B.V.; 2013. p.1735-83.
5. Tafuto S, Catalano O, Barba G, Sandomenico F, Lobianco R, Tortoriello A,et al. Real-time contrast-enhanced specific ultrasound in staging and follow-up of splenic lymphomas. Front Biosci 2006; 11: 2224-9. [CrossRef]
6. Miura K, Fukumoto T, Hori T, Yoshizawa K, Morita J. Postpneumonec- tomy space control with SF6. Jpn J Surg 1991; 21: 392-4. [CrossRef]
7. Kraut A, Lilis R. Pulmonary effects of acute exposure to degradation pro- ducts of sulphur hexafluoride during electrical cable repair work. Br J Ind Med 1990; 47: 829-32.
8. Sittig, M. Handbook of Toxic and Hazardous Chemicals and Carcino- gens. 4th ed. Norwich, NY: Noyes Publications; 2002. p.2119.

9. Sulfur hexafluoride in http://toxnet.nlm.nih.gov/. Hazardous Substan- ces Databank Number: 825. Last Revision Date: 2007/10/11. U.S. Natio- nal Library of Medicine National Institutes of Health.
10. Currance PL, Clements B, Bronstein AC. Emergency Care for Hazardous Materials Exposure. 3th ed. St. Louis: Elsevier Mosby MO; 2005. p.439-40.