II. Background
- Sulfuryl Fluoride is a gas used to fumigate coastal structures for termites
- Gas is colorless and odorless and accumulates in low areas (heavier than air)
- Humans are exposed via inhalation of gas
- Exposure limit over short term is 10 ppm
- Toxic or lethal dose 200 ppm
III. Adverse Effects
- Electrolytes
- Cardiovascular
- Arrhythmia
- QRS Widening
- QTc Prolongation
- Hemodynamic instability
- Gastrointestinal
- Respiratory
- Neurologic
IV. Labs
- Serum Electrolytes and acid-base
- Serum Calcium Decreased
- Serum Magnesium decreased
- Serum Potassium decreased
- Acidosis
V. Diagnostics
VI. Management
- Remove patient from exposure
- Decontamination
- ABC Management
-
Electrolyte replacement
- Hypocalcemia Management
- Hypomagnesemia Management
- Hypokalemia Management
-
Arrhythmia Management
- Consider Amiodarone for Ventricular Arrhythmia
-
Seizure Management
- See Status Epilepticus
- Consider Phenobarbital for refractory Seizures (after initial Benzodiazepines)
- Disposition - Emergency discharge indications (all others should remain for hospital observation)
- Observed for 4-6 hours without symptoms
- No acute EKG abnormalities (QTC normal, QRS width normal)
- No Hemodynamic instability
VII. References
- Tomaszewski (2020) Crit Dec Emerg Med 34(11): 28
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Related Studies
| Concepts | Hazardous or Poisonous Substance (T131) , Inorganic Chemical (T197) |
| MSH | C048899 |
| SnomedCT | 4435007 |
| English | sulfonyl fluoride, sulfuryl fluoride, Sulfuryl fluoride, Sulfuryl fluoride (substance), Sulphuryl fluoride |
| Spanish | sulfurilfluoruro (sustancia), sulfurilfluoruro |
