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I-Hydrogen Sulfide (I-Sewer Gas), i-Cyanide, ne-Toxic Gas Inhalation Rescue

Izinombolo zezimo eziphuthumayo ziyehluka ngezwe. Leli khasi lisebenzisa u-911, inombolo yase-United States naseCanada. Amanye amazwe amaningi asebenzisa u-112, 999, noma enye inombolo. Thola inombolo yezwe lakini.

Ukuhogela igesi enobuthi ephezulu yezimboni, yezolimo, noma yasendlini: ikakhulukazi i-hydrogen sulfide (\(H_2S\) / ipayipi lendle negesi yomquba), i-hydrogen cyanide (\(HCN\) / intuthu yomlilo wesakhiwo ne-industrial cyanide), chlorine noma igesi ye-chloramine (ingxube ye-bleach cleanermoni ibangelamonini,, izihlanzi ze-bleach zasendlinimoni,**, ukwehluleka ukuphefumula okubeka engcupheni impilo noma ukufiphala kwamaselula ngokushesha phakathi nemizuzwana. Okudabukisa nakakhulu ukuthi, izigameko zegesi enobuthi zivame ukubulala abanye ababengaba abatakuli kunezisulu zangempela: lapho isisebenzi, umlimi, noma ilungu lomndeni liwa phansi komsele, ithange lendle, umgodi womquba, indawo yokubamba umkhumbi, noma igumbi elingaphansi, osebenza nabo noma izihlobo ezijaha ukubamba umoya ngaphandle kwe-Self-Containtused by Breathing I-SCBA eyodwa bafe eduze komuntu ababezama ukumsindisa.

Lo mhlahlandlela uhlinzeka ngesinyathelo ngesinyathelo senkambu yezinqubo zokuhlenga kanye nezinqubo zomtholampilo ezihambisana neziqondiso ezivela ku-World Health Organization (WHO), i-United States National Institute for Occupational Safety and Health (NIOSH), i-Occupational Safety and Health Administration (OSHA), i-Centers for Disease Control and Prevention (CDC), kanye ne-UK Health Security Agency (UKHSA). Ukuphoqelela **umthetho oqinile wokungangeni endaweni evalekile *, ukuqonda i-hydrogen sulfide olfactory paralysis (kungani uyeka ukuhogela amaqanda abolile ngaphambi nje kokuphefumula okubulalayo), ukunikeza iphesenti elingu-100 lomoya-mpilo ogelezayo ophezulu, kanye nokuletha i-hydroxocobalamin (Cyanokit) ngokushesha ukuze i-cyanide isindise izimpilo.

Yenza lokhu manje

Uma ubona othile edilika ngaphakathi noma eduze komsele, umzila wendle, ithange le-septic, umgodi womquba wasepulazini, isisele sokusanhlamvu, imoto yethangi, igumbi lamakhemikhali, igumbi elinentuthu, noma igumbi lokugezela elingenawo umoya ohlanzekile lapho bekuxutshwe khona abahlanzi:

  1. YIMA: UNGALOKOTHI ungene endaweni evalekile, umgodi, igumbi elingaphansi, noma ifu legesi ngaphandle kwe-SCBA: Ngisho noma umuntu odindilizile kuyingane yakho, umngane womshado, noma osebenza naye, ungehli ngesitebhisi futhi ungazami ukubamba umoya bese ugijima ungene. Ukuphefumula okukodwa kwe-concentrated hydrogen sulfide (\(> 700\text{kuya }1,000\text{ppm}\)) noma i-hydrogen cyanide kuquleka umuntu omdala ku-*1 kuya kusekhondi elingu-3 ("i-knockdown")**, kanye nezifihla-buso zegesi yokuhlunga noma izindwangu ezimanzi phezu kobuso bakho zinikeza ukuvikelwa -i-oxygen eyiziro Abacimi bomlilo kuphela abafakwe ingcindezi eqondile I-Self-Contained Breathing Apparatus (SCBA) kanye newintshi yokubuyisa eboshiwe ezingangena ngokuphepha.
  2. Zikhiphe wena nabanye nikhuphuke futhi nikhuphuke ngokushesha: Hamba okungenani ngamamitha angu-30 kuye kwayi-100 (amafidi angu-100 ukuya kwangu-330) ukhuphukele phezulu futhi uye endaweni ephakeme. I-Hydrogen sulfide (\(H_2S\)), i-chlorine (\(Cl_2\)), ne-phosgene (\(COCl_2\)) isinda kunomoya futhi ichitheka emiseleni ephansi, ezindlini ezingaphansi, indle, nasezigodini. Uma igesi enobuthi yakhiqizwa endlini (isibonelo, ngokuxuba i-bleach ne-ammonia noma i-asidi yesitsha sendlu yangasese endlini yokugezela), khipha wonke umuntu endlini ukuze aye emoyeni omusha wangaphandle ngokushesha futhi ushiye iminyango ivuliwe lapho uphuma.
  3. Shayela inombolo yakho yasendaweni yezimo eziphuthumayo ngokushesha ukuze uthole I-Fire/HAZMAT Confined-Space Rescue: Shayela ku-911 e-United States nase-Canada, ku-112 ku-European Union yonkana, noma 999 e-United Kingdom (noma uhlole izinombolo eziphuthumayo umkhombandlela). Tshela umthumeli ngokucacile: "Indawo evalekile / ukugoqa kwegesi enobuthi: isisulu phansi [kumandle / umgodi womquba / ukuchitheka kwamakhemikhali angaphansi / amakhemikhali]. Thumela uMnyango Wezomlilo i-HAZMAT ne-SCBA kanye ne-Cyanide Antidote (Hydroxocobalamin)."
  4. Landa kuphela isisulu uma ungakwenza lokho NGAPHANDLE kwendawo eyingozi: Ungakhipha isisulu kuphela uma sesivele sigqoke ihhanisi lokuphepha elixhunywe kwiwintshi/i-tripod eyimishini yangaphandle ngaphandle komgodi, noma uma silele emnyango ovulekile lapho ungakwazi ukufinyelela khona usuka emoyeni ophuma ngaphandle ohlanzekile ngaphandle kokuwela umbundu.
  5. Uma isisulu sesinomoya ohlanzekile, khumula izingubo zangaphandle bese uhlola ukuphefumula: Ngenxa yokuthi amagesi afana ne-hydrogen sulfide ne-hydrogen cyanide avaleleke ngaphakathi emicu yezingubo ayaqhubeka nokuphuma igesi ebusweni bomuntu ohlukunyeziwe kanye nomhlengi, akhiphe ngokushesha ibhantshi langaphandle, ihembe, nebhulukwe lesisulu. Hlola ukuphefumula okuvamile:
  6. Uma ungaphefumuli noma uhefuzela kuphela: Qala ukucindezelwa kwesifuba ngezandla kuphela (CPR) noma sebenzisa i-bag-valve-mask (BVM) exhunywe kumaphesenti angu-100 oksijini. UNGALOKOTHI wenze ukuvuselela komlomo nomlomo okuqondile kusisulu se-cyanide noma se-hydrogen sulfide, njengoba umoya waso awukhiphayo uqukethe igesi enobuthi engaba ubuthi kumhlengi.
  7. Uma uphefumula: Zibeke endaweni enethezekile (zimiswe ziqonde uma zikhwehlela/uhefuzela ngenxa ye-chlorine/ammonia, noma ohlangothini lwazo lapho zisesimweni sokululama uma zozela) futhi unikeze u-100% womoya-mpilo ogeleza kakhulu usebenzisa imaski engaphefumuli kabusha ngokushesha nje lapho i-EMS ifika.
  8. Fahla amehlo ashisayo nesikhumba ngamanzi agobhozayo imizuzu eyi-15: Uma amagesi acasulayo (i-chlorine, i-ammonia, i-sulphur dioxide, i-hydrogen fluoride) eshisa amehlo noma isikhumba esimanzi, shayela ngokuqhubekayo ngamanzi agelezayo ahlanzekile noma i-saline evamile imizuzu eyi-15 (bona ukulimala kwamehlo futhi ukusha okukhulu nokushiswa kwamakhemikhali).

Kungani u-60% wabantu abashonile endaweni evalelwe kungabatakuli, futhi kungani ikhala lakho lilele kuwe

Ngokophenyo lwase-US I-NIOSH kanye ne-OSHA, ngaphezu kwamaphesenti angu-60 abo bonke abasebenzi abashona endaweni evalekile i-hydrogen sulfide, umgodi womquba, kanye nezingozi zokuphefumula okungabahlengikazi abangagunyaziwe abangene ukuze bakhiphe isisebenzi sokuqala esidilikile. Ukwengeza, ungalinge uthembele kunzwa yakho yokuhogela ukuze wahlulele ukuthi i-Hydrogen Sulfide (\(H_2S\)) ikhona yini: kuyilapho amazinga aphansi, angabulali angu-\(H_2S\) (0.01 kuya ku-30 ppm) enuka kakhulu amaqanda abolile, lapho ukugxila kunqamula 100 kuya ku-150 ppmze inzwa yakho ekhubazekile* (ukukhathala okuphuphumayo)**. Iphunga leqanda elibolile livele linyamalale ngokuphelele, likukhohlise ukuthi ucabange ukuthi umoya usuphelile ngaphambi nje kokuba ukuphefumula okukodwa ku-500 kuya ku-1,000 ppm kubangela ukukoma osheshayo kanye nokuboshwa kokuphefumula.

Ishadi lokuhlenga lezindawo eziphuthumayo kanye neshadi lokuphindaphinda kwegesi enobuthi

flowchart TD
    Start["Isisulu Sigoqekile noma Sihefuzela Esikhaleni Esivalekile, Kutakula, Umgodi Wobulongwe, Intuthu, noma Ifu Lekhemikhali"] --> Location{"Sitholakala kuphi isisulu njengamanje?"}

    Location -->|Inside manhole, pit, tank, silo, basement, or dense gas cloud| StayOut["UNGANGENA NGAPHANDLE kwe-SCBA<br/>Shayela ku-911 / 112 / 999 ukuze uthole Ukutakulwa koMnyango Wezomlilo HAZMAT<br/>Vula amafeni aphuma ngaphandle noma usebenzise iwintshi yangaphandle KUPHELA emoyeni ophephile"]

    Location -->|Already rescued into fresh upwind outdoor air| Decon["Hlubula izingubo zangaphandle ezibamba igesi emoyeni ovulekile<br/>Hlola ukusabela nokuphefumula"]

    StayOut -->|Firefighters with SCBA extract victim to fresh air| Decon

    Decon --> BreathCheck{"Ingabe isisulu siphefumula ngokujwayelekile?"}

    BreathCheck -->|No: Apneic or Agonal Gasps| CPR["Qala i-CPR Yezandla Kuphela + Isikhwama-Valve-Mask (BVM) ne-100% O2<br/>UNGALOKOTHI wenze ukuphefumula okuqondile komlomo nomlomo"]
    BreathCheck -->|Yes: Breathing spontaneously| HighO2["Lawula i-100% High-Flow Oxygen (Imaski Engaphefumuli Kamuva)"]

    CPR --> GasID{"Thola Indlela Yegesi Ngesigcawu Nezimpawu"}
    HighO2 --> GasID

    GasID -->|House/building fire smoke, jewelry/electroplating shop, industrial nitrile;<br/>soot in mouth, coma, seizures, shock, Lactate > 8-10 mmol/L| Cyanide["I-Cyanide (HCN) esolwayo + Ne-Carbon Monoxide Poisoning<br/>I-IV Hydroxocobalamin Esheshayo (Cyanokit 5 g IV ngaphezu kwamaminithi angu-15)<br/>+ I-Sodium Thiosulfate (12.5 g IV) + 100% Oxygen"]

    GasID -->|Sewer, septic tank, manure pit, oil/gas sour crude, geothermal;<br/>sudden 'knockdown' collapse, blackened silver coins/jewelry| H2S["I-Hydrogen Sulfide (H2S / 'Sewer Gas') Ubuthi<br/>100% I-oksijeni Egeleza Kakhulu + Intubation esheshayo uma i-comatose<br/>Ukunakekelwa okusekela kwe-ICU (I-Nitrites / Cobinamide nge-toxicologist ngayinye)"]

    GasID -->|Mixed household bleach + ammonia or acid cleaner, pool chlorine,<br/>or industrial tank leak; immediate choking, coughing, stridor, wheezing| Irritant["Igesi Ecasulayo Encibilikayo (I-Chlorine, i-Chloramine, i-Ammonia)<br/>Amehlo ashisayo/isikhumba 15 min; hlala uqonde; I-Oxygen emswakama<br/>I-Nebulised Albuterol + Nebulized 2% -3.75% Sodium Bicarbonate (ye-Chlorine)"]

    GasID -->|Welding on chlorinated solvents (brake cleaner), Teflon overheating,<br/>or silo grain gas (NO2); mild early cough -> severe pulmonary edema 4-24h later| DelayedGas["I-Low-Solubility Irritant Gas (I-Phosgene, I-Nitrogen Dioxide)<br/>ISIMFUNDO ESIYISIMELEKO Ukubuka Isibhedlela Samahora angu-24 ngisho noma uzizwa ukahle manje<br/>Ukuphumula ngokomzimba okuqinile; I-PEEP / CPAP ye-edema yamaphaphu ebambezelekile"]

I-Pathophysiology ye-"Cellular Asphyxiants": I-Cyanide (\(HCN\)) ne-Hydrogen Sulfide (\(H_2S\))

Ngokungafani nokuminyanisa ukudla (okuvimbela umoya ukuba ungangeni kuqhoqhoqho) noma ukuminza (okugcwalisa amaphaphu ngamanzi), I-Hydrogen Cyanide (\(HCN\)) kanye ne-Hydrogen Sulfide (\(H_2S\)) "ama-chemical / cellular asphyxiants" (ebizwa nangokuthi ama-gases ****-nock). Uma uhogela u-\(HCN\) noma u-\(H_2S\), amaphaphu akho asagcwele umoya-mpilo futhi amangqamuzana akho abomvu egazi asathwele umoya-mpilo omningi emithanjeni yakho: kodwa amangqamuzana omzimba wakho avinjwe amakhemikhali ukuze angasebenzisi lowo moya-mpilo, okubangela ubuchopho nenhliziyo yakho ukuthi ingasebenzi ngaphakathi ngemizuzwana.

I-Cytochrome c Oxidase Inhibition ikumisa kanjani ukuphefumula kwamaselula

Ngaphakathi kwe-mitochondria yawo wonke amangqamuzana omuntu, isinyathelo sokugcina sokukhiqizwa kwamandla e-aerobic (i-oxidative phosphorylation) sincike ku-enzyme Cytochrome c Oxidase (I-Complex IV ye-electron transport chain), equkethe i-iron ferric emaphakathi (\(Fe^{3+}\)) kanye nomgogodla wethusi odlulisela ama-electron* (ama-electron*_ATP) agcina ama-electron2ATP ku-oxygen. ama-neurons obuchopho nokushaya kwemisipha yenhliziyo).

  1. I-Iron Binding Esheshayo: Kokubili i-cyanide (\(CN^-\)) nama-ion e-hydrosulfide (\(HS^-\)) abopha ngokuhambisana okunonya ngokuqondile ku-iron iron (\(Fe^{3+}\)) engaphakathi kwe-mitochondrial cytochrome c oxidase.
  2. Ukuvala Okuphelele kwe-ATP kanye Nokuqhuma Kwe-Lactic Acid: Njengoba i-Complex IV ivaliwe, i-mitochondria ngeke isakwazi ukusebenzisa umoya-mpilo noma ikhiqize i-ATP ye-aerobic. Eswele amandla, amaseli ashintshela esimeni esiphuthumayo kuphela i-anaerobic glycolysis, ekhiqiza ingxenye encane kuphela ye-ATP edingekayo kuyilapho elahla ubuningi be-lactic acid egazini (serum lactate ikhuphuka ngokushesha ngaphezu kuka-8 kuya ku-10 mmol/L).
  3. Okwenza Igazi Le-Venous Libukeke "I-Cherry Red" (I-Arterialization of Venous Blood): Ngenxa yokuthi izicubu zomzimba azikwazi ukukhipha umoya-mpilo kumangqamuzana abomvu egazi adlulayo, igazi elibuyela ngemithambo libuyela enhliziyweni lisecishe libe amaphesenti angu-90 kuya kwangu-95 agcwele umoya-mpilo (esikhundleni sokugcwala kwe-venous okungamaphesenti angu-70). Lapho abahlengikazi bedonsa isampula legazi le-venous engalweni yesisulu se-cyanide, igazi le-venous libukeka ngendlela emangazayo i-arterial ebomvu ekhanyayo, kanye nesihloko somunwe esijwayelekile ama-pulse oximeters (\(SpO_2\)) afundeka amanga "98% kuya ku-100%" ngisho noma isiguli sibulawa i-hypoxia yeselula.

Ukuqhathanisa okuyinhloko kokuxilonga kwe-Industrial, Agricultural, kanye namagesi anobuthi asekhaya

I-Gas & Chemical Formula Imithombo Evamile Nezigcawu Ezinobungozi obukhulu Iphunga, Ukuminyana kanye Nezimpawu Zomzimba I-Toxicological Mechanism Isethulo Somtholampilo Esijwayelekile I-Definitive Antidote Nokuphathwa Kwesibhedlela
I-Hydrogen Cyanide (\(HCN\)) Nosawoti We-Cyanide Intuthu yomlilo yesakhiwo/isakhiwo somlilo (uboya obuvuthayo, usilika, igwebu le-polyurethane, inayiloni, amapulasitiki, i-melamine), izimayini zegolide/zesiliva, i-electroplating, ukuhlanzwa kobucwebe, isikhiphi sezinzipho se-acetonitrile, i-sodium nitroprusside, imigodi yamabhilikosi/umdumbula. Iphunga le-alimondi elibabayo (litholakala kuphela ngama-40%, ama-60% abantu ngokofuzo); ilula kunomoya (\(HCN\) gas). Umsele ozungeze umlomo/emakhaleni kwizisulu zomlilo. Ibophezela i-\(Fe^{3+}\) kokuthi mitochondrial Cytochrome c Oxidase \(\rightarrow\) imisa ukusetshenziswa komoyampilo weselula \(\rightarrow\) fulminant anaerobic lactic acidosis. "I-Knockdown" iyawa ngemizuzwana kumazinga aphezulu egesi; ukudideka, i-tachypnea ehefuzelayo elandelwa i-apnea, isithuthwane, i-coma, ukuwa kwenhliziyo nemithambo yegazi/bradycardia, kanye I-Serum Lactate >= 8 to 10 mmol/L. 1. I-Oxygen Egeleza Kakhulu engu-100%.
2. I-IV Hydroxocobalamin (i-Cyanokit 5 g IV ngaphezu kwemizuzu eyi-15) (ibopha i-cyanide ukuze yakhe i-Vitamin B12 engenabungozi ekhishwa emchamweni).
3. IV I-Sodium Thiosulfate (12.5 g IV).
I-Hydrogen Sulfide (\(H_2S\) / "Igesi Yendle" / "Igesi Emuncu") Izitamkoko, amathangi e-septic, amachibi okugeza amanzi, izindawo zokugcina amanzi ezisetshenziswa ngaphansi komhlaba, imigodi yobulongwe obuwuketshezi lwezolimo, izindawo zokuhluza zikaphethiloli/zegesi yemvelo ("okungahluziwe okumuncu"), izigayo zephepha, izimboni zesikhumba, iziphethu ezishisayo/izimbobo zentaba-mlilo, **ukuxuba i-asidi yasendlini yangasese nemikhiqizo yesulphur.*"i-detergent). Iphunga lamaqanda abolile emazingeni aphansi (< 30 ppm), kulandelwa ** ukukhubazeka okuphelele kwezinzwa ze-olfactory ngenhla kwe-100 kuya ku-150 ppm **; isinda kunomoya (ishona emigodini); yenza ibe mnyama izinhlamvu zemali zethusi nobucwebe besiliva emaphaketheni ezisulu. Ibophezela i-\(Fe^{3+}\) ku-mitochondrial Cytochrome c Oxidase (efana ne-cyanide) + ukulimala okuqondile komucosa okubola emehlweni naku-alveoli. Amazinga aphansi (10 kuya ku-100 ppm): "Iso Legesi" (i-keratoconjunctivitis ebuhlungu, amehlo anomunyu, ama-halo azungeze izibani) + ukukhwehlela.
Amazinga aphezulu (> 500 to 1,000 ppm): Ukuphefumula okukodwa "I-Slaughterhouse Sledgehammer Knockdown" (i-coma esheshayo, isithuthwane, i-apnea, nokuboshwa kwenhliziyo).		 1. Ukuhlenga Okuqinile kwe-SCBA Okuvalekile.
2. Hlikihla izingubo futhi unikeze 100% I-High-Flow Oxygen / Intubation (\(H_2S\) ihlukanisa ngokushesha kune-cyanide nge-\(O_2\)).
3. I-IV Sodium Nitrite (300 mg) noma I-Hydroxocobalamin uma inikezwa ngokushesha (bona Ukulawula Ubuthi).
I-Chlorine (\(Cl_2\)) ne-Chloramine (\(NH_2Cl\)) Igesi Ukuxuba i-sodium hypochlorite bleach yasendlini ne-Ammonia (\(\rightarrow\) Chloramine gas) noma ne-Acid toilet bowl cleaner / uviniga / muriatic acid (\(\rightarrow\) pure Chlorine gas); amagumbi amakhemikhali echibi lokubhukuda; ukuvuza kwesitshalo sokuhlanza amanzi. Iphunga le-bleach elishisayo, elicishayo/idamu lokubhukuda; i-greenish-yellow haze ekugxilweni okuphezulu; I-Chlorine isinda ngo-2.5x kunomoya. Ukuncibilika kwamanzi okumaphakathi: Incibilika kumswakama womoya ukuze kwakheke I-Hydrochloric Acid (\(\text{HCl}\)) kanye ne-Hypochlorous Acid (\(\text{HOCl}\)), ivutha kusukela emphinjeni kwehle kuya ku-alveoli. Ukukhwehlela okunodlame ngokushesha, ukuklinywa, ukuvutha kwamehlo/umphimbo, ubuhlungu besifuba obubuyela emuva, i-laryngospasm (stridor), obukhulu i-bronchospasm (wheezing), kanye ne-acute non-cardiogenic pulmonary edema. Phuma emoyeni omusha; amehlo ahlanzekile 15 min; ** 100% Oxygen Humidified **; I-Albuterol ene-Nebulised yokuhefuzela + I-Nebulize 2% kuya ku-3.75% ye-Sodium Bicarbonate (4 mL) ukuze kuncishiswe i-asidi yomoya.
I-Anhydrous Ammonia (\(NH_3\)) Amathangi kamanyolo wezolimo, izimboni zesiqandisi ezibandayo/i-ice-rink, amalebhu e-methamphetamine, izihlanzi zezimboni. Iphunga le-ammonia eliphuphuma ngokunamandla; ilula kunomoya (ngaphandle kwalapho ifu le-aerosol eliwuketshezi elibandayo, eligona phansi). Ukunyibilika okuphezulu kwamanzi: Isabela ngokushesha ngomswakama emehlweni, emlonyeni, kanye nendlela yomoya ephezulu (umphimbo/uqhoqhoqho) ukuze yakhe i-caustic I-Ammonium Hydroxide (\(\text{NH}_4\text{OH}\)) ukusha kwe-alkali. Inhlekelele yendlela yomoya ephezulu: Ukusha koketshezi oluphuphuthekayo lwekhone, ukuvuvukala okukhulu kwezindebe/ulimi/i-epiglotti, izwi elihhadlazelayo, i-stridor ephefumulayo ephezulu, kanye nokuminyaniseka komzila womoya ophezulu ngokushesha. Hlanza amehlo nesikhumba ngamanzi amaningi okungenani imizuzu eyi-15 ukuya kwengama-30; i-early endotracheal intubation (ngaphambi kokuvuvukala komphimbo uvale ngokuphelele); ama-humidified \(O_2\) nama-bronchodilators.
I-Phosgene (\(COCl_2\)) ne-Nitrogen Dioxide (\(NO_2\) / "Silo Filler's Disease") I-Phosgene: Ukushisela, ukubhula, noma insimbi yokususa ukushisa ehlanzwe nge-i-chlorinated brake cleaner (i-tetrachlorethylene / trichlorethylene); ukushisa amaFreon/amafriji.
Nitrogen Dioxide (\(NO_2\)): Okusanda kugcwaliswa okusanhlamvu kwasepulazini/izisele zommbila (amaviki amabili okuqala); i-diesel exhaust; ukuchithwa kwe-nitric acid.		 I-Phosgene: Inuka kamnandi njengokuthi utshani obusanda kugaywa noma ummbila osikiwe oluhlaza.
\(NO_2\): Igesi elisindayo elibomvu ngokunsundu ngaphansi kwezisele elinephunga elibukhali njenge-bleach.		 Ukuncibilika kwamanzi okuphansi: Ngenxa yokuthi AKUNYILUKI ekhaleni elimanzi noma emphinjeni, abangela ukukhwehlela kwangaphambi kwesikhathi okuncane, okuvumela isisulu ukuthi sikuhogele sijule ku-alveoli, lapho sishintsha kancane sibe ngu-\(\text{HCl}\) noma \(\text{HNO}_3\) ngaphezulu kwamahora angu-4 kuya kwangu-24*. Isigaba Esifihlekile Samahora angu-4 kuya kwangu-24: Ukukhwehlela okuncane noma ukukitaza kwesifuba ekuqaleni; isisulu siya ekhaya sizizwa siphilile, bese sivuka phakathi nobusuku amahora angu-6 kuya kwangu-24 kamuva sigwiliza ku-edema enkulu yamaphaphu ebambezelekile (ARDS). Ukubhekwa okuphoqelekile kwesibhedlela kwamahora angu-24 ngemva kwanoma yikuphi ukuphefumula okuqinisekisiwe kwe-phosgene noma i-silo-gas (ngisho noma kungenazimpawu ngokuphelele); ukuphumula kombhede okuqinile; ukungena komoya kwangaphambi kwesikhathi kwe-CPAP / PEEP.
Ama-Asphyxiants Alula (I-Carbon Dioxide [\(CO_2\)], i-Nitrogen [\(N_2\)], i-Methane [\(CH_4\)], i-Argon, i-Helium, i-Propane) Iqhwa elomile i-sublimating ezimotweni ezivaliwe/ama-walk-in coolers; izimbiza zewayini/zobhiya (\(CO_2\)); i-liquid nitrogen dewars; umkhumbi amathangi e-ballast agqwalile (ukuncipha komoya-mpilo); ukuvuza kwegesi yemvelo. Ayinaphunga ngokuphelele, ayinambala, futhi ayicunuli (\(CO_2\) ne-Argon zisinda kunomoya; I-nitrogen ne-Methane ilula). Isusa umoya-mpilo womkhathi (\(O_2\)) ngaphansi kokujwayelekile okungu-20.9% kwehle kuye < 10%, 12% ngaphandle kokubangela ukusha kwendlela yokuphefumula. Ukuphefumula okusheshayo, isiyezi, ukubona emhubheni, ukudideka, injabulo, kanye nokulahlekelwa ukwazi kungazelelwe ngaphandle kokukhwehlela okuyisixwayiso lapho i-\(FiO_2\) yehla ngaphansi kuka-10%; ukuboshwa kwenhliziyo kungakapheli imizuzu. I-SCBA ihlenga emoyeni omusha ongu-21% wangaphandle + 100% Oksijini kanye ne-CPR uma i-apneic. Ukululama kuyashesha futhi kuphelele uma kusindiswa ngaphambi kokulimala kobuchopho be-hypoxic.

I-Deep 1: I-Hydrogen Sulfide (\(H_2S\)): Igesi "yeKnockdown" kanye Nohlamvu Lwemali Olumnyama

IHydrogen sulfide (\(H_2S\)) iyimbangela yamakhemikhali engu-#1 yokufa kungazelelwe emsebenzini ekulungiseni indle, ukupompa indle, ukukhipha uwoyela negesi ("igesi emuncu"), kanye nokufuywa kwemfuyo.

Kungani ukunyakazisa umgodi womquba wasepulazini noma ukuvula isicupho sendle kudala inhlekelele esheshayo

Njengoba amabhaktheriya e-anaerobic ephula amaprotheni anesulfure emanzini angcolile abantu noma uketshezi lwengulube/umanyolo wobisi ogcinwe ngaphansi kwezitezi zezibaya, inani elikhulu lokuncibilika i-hydrogen sulfide (\(H_2S\)), methane, ammonia, kanye ne-carbon dioxide* avaleleka ngaphansi koqweqwe oluwuketshezi.

  1. I-Slurry Agitation Spike: Ngesikhathi umlimi evula iphampu ukuze anyakazise umgodi womquba owuketshezi ngaphambi kokumpompa, noma osebenza ngepayipi evula isicupho esivimbile sendle, avalele amabhamuza egesi angu-\(H_2S\) aphume ngobudlova ekuxazululeni inkinga: ukushayela igumbi noma ukugxila komoya womgodi usuka endaweni ephephile engu-5 ppm ukuya ku-ngaphezu kuka-6ppm isekhondi elingaphansi kuka-00*0
  2. Imiphumela encike ekugxilweni kwe-\(H_2S\):
  3. 0.01 kuya ku-0.3 ppm: Umkhawulo wephunga: ohlukile iqanda elibolile iphunga (alinangozi ngokuphelele kuleli zinga lokulandela umkhondo).
  4. 10 kuya ku-50 ppm: "Iso Legesi" (Keratoconjunctivitis): ukuluma, ukudabuka kwamehlo, ubuhlungu "besihlabathi esisemehlweni", i-photophobia, kanye nokubona ama-rainbow azungeze izibani, kanye nomphimbo obuhlungu nokukhwehlela.
  5. 100 kuya ku-150 ppm (IDLH: Iyingozi Ngokushesha Empilweni Noma Empilweni): Ukukhubazeka okuphelele komthambo wokunuka phakathi nemizuzu emi-2 kuya kweyi-15. Ngeke usakwazi nhlobo ukuhogela amaqanda abolile.
  6. 500 kuya ku-700 ppm: Ukuwa okumangalisayo, ukukoma, nokukhubazeka kokuphefumula phakathi** nemizuzu engu-1 ukuya kwemi-5**.
  7. 700 kuya ku-1,000+ ppm ("Slaughterhouse Sledgehammer"): Ukuwisa ngokuphazima kweso UPHEFUMULO LOKUQALA KAKHULU. Isisulu siwela phansi njengokungathi sishaywe ekhanda ngesando, siyayeka ukuphefumula ngokushesha ngenxa yokukhubazeka kwesikhungo sokuphefumula kwenhliziyo, futhi sihlushwa i-hypoxic.
  8. Inkomba "Yezinhlamvu Ezimnyama Nobucwebe Besiliva" Yabaphenduli Bokuqala: I-Hydrogen sulfide isabela ngokushesha lapho ithintana nethusi, ithusi, nezinsimbi zesiliva kwakheka emnyama i-sulfide yethusi noma i-sulfide esiliva. Uma abezimo eziphuthumayo befika endaweni edilikayo ngendlela engaqondakali egumbini elingaphansi, igumbi lokugezela, igumbi lehhotela, noma indawo yezimboni bese beqaphela ukuthi ikota, ama-dimes, amapennies, amabhande ebhande lethusi, noma izindandatho/imigexo esiliva kumuntu ohlukunyeziwe kuphenduke amalahle amnyama aba mnyama, umsolwa *I-Hydrogen Sulfide ($H_2 isuse amamitha ngokushesha futhi igeze umlilo)

I-Deep 2: I-Cyanide ku-House Fires kanye ne-Hydroxocobalamin (Cyanokit) Revolution

Iningi labantu liyazi ukuthi i-Carbon Monoxide (\(CO\)) iyigesi ebulalayo endlini yesakhiwo kanye nemililo yokwakha (bona I-carbon monoxide kanye nomhlahlandlela wokuhogela intuthu). Abantu abaningi abangakuqapheli ukuthi imililo yezindlu yanamuhla ifana nesimo esiphuthumayo se-Hydrogen Cyanide (\(HCN\)).

Kungani impahla yasendlini yokwenziwa yesimanje ikhiqiza intuthu ebulalayo ye-Cyanide

Eminyakeni engu-50 edlule, ifenisha, okhaphethi, namakhethini kwakwenziwa ngokotini lwemvelo nokhuni, okwakushiswa ngokuyinhloko kube yi-carbon monoxide. Namuhla, amakhaya namahhovisi agcwele ama-polymers okwenziwa ane-nitrogen: i-polyurethane foam umatilasi namakhushini osofa, okhaphethi benayiloni, izingubo zokulala ze-acrylic, ama-melamine laminate, izintambo ze-PVC, kanye noboya bemvelo nosilika. Uma lezi zinto zokwenziwa zivutha noma zishibilika emlilweni wegumbi onomoya-mpilo omncane omncane, zikhulula amafu aminyene egesi I-Hydrogen Cyanide (\(HCN\)).

  • Ababulali Abakabili Bokuhogela Intuthu: I-Carbon monoxide (\(CO\)) ​​ne-Hydrogen Cyanide (\(HCN\)) benza ngokuvumelana ukuze babulale isisulu sokuhogela intuthu. Ngenxa yokuthi i-\(HCN\) inesigamu sempilo** esifushane izikhathi ezingu-35 futhi ibangela ikhoma esheshayo, i-apnea, kanye ne-hypotension phakathi nemizuzwana, noma ubani odonswe equlekile noma obanjwe inhliziyo emlilweni ovalekile onomusi emlonyeni noma emakhaleni kufanele alashwe *kokubili ubuthi be-Carbon monoxide KANYE NE-Cyanide endaweni.

Kungani iHydroxocobalamin (Cyanokit) iyikhambi elisezingeni legolide ekuhogeleni intuthu

Ngokomlando, izibhedlela zelaphe ubuthi be-cyanide nge-zinyathelo ezintathu ze-Taylor / Lilly Cyanide Antidote Kit endala (Amyl Nitrite ehogelwe ama-ampules + Intravenous Sodium Nitrite + Intravenous Sodium Thiosulfate). Asebenza kanjani ama-nitrites? I-sodium nitrite ikhiphe ngamabomu amaphesenti angu-10 kuya kwangu-20 ehemoglobin evamile yesiguli ethwala umoya-mpilo yaba yi-Methemoglobin (\(Fe^{3+}\)), eyabe ikhipha i-cyanide ku-mitochondria ukuze yakhe i-cyanmethemoglobin.

  • Kungani UNGALINGE Unike isisulu sokuhogela intuthu yomlilo endlini yokusha: Emzini oshayo amangqamuzana egazi abomvu asenamaphesenti angu-20 kuya kwangu-40 kakade afakwe ubuthi be-Carbon Monoxide (carboxyhemoglobin)**, ejova I-Sodium Nitrite iguqula amanye amaphesenti angu-20 e-hemoglobin yaso esele ibe amandla aso angenawo umoya-mpilo futhi akhiphe i-oksijini ekugcineni* kubangela ukuphefumulelwa okubulalayo.
  • Indlela i-Hydroxocobalamin (Cyanokit) esindisa ngayo izisulu zokuhogela intuthu ngokuphephile:
  • I-Hydroxocobalamin iyisandulela semvelo sikaVithamini B12 (\(B_{12a}\)). Ingqamuzana ngayinye ye-hydroxocobalamin iqukethe i-cobalt ion ephakathi ebophezela ngokuqondile ku-cyanide ion enokusondelana okukhulu kune-cytochrome c oxidase, yakhe i-Cyanocobalamin (i-Vitamin B12 evamile, engeyona enobuthi), ekhishwa ngokungenabungozi emchamweni: ngaphandle kokudala noma iyiphi i-metry blood pressure futhi ngaphandle kokunciphisa i-metry blood pressure futhi ngaphandle kokunciphisa i-blood pressure oxide futhi inyusa ngokushesha umfutho wegazi ezigulini ezishaqekile).
  • Umthamo Wabantu Abadala: amagremu angu-5 ngokufakwa emthanjeni ngaphezu kwemizuzu engu-15 (ingaphindwa kanye ngengqikithi yamagremu angu-10 ekuboshweni kwenhliziyo noma ukushaqeka okungapheli; umthamo wezingane ngu-70 mg/kg IV*, max 5 g), ngokuvamile ubhangqwe ngomugqa ohlukile we-IV ne **Sodium Thiosulfate (12.5, amagremu angu-12,5, amagremu alandelayo) rhodanese ukuguqula i-cyanide ibe yi-thiocyanate engenabungozi.
  • Umphumela Ongase Ulimele Ongawulindela: Ngenxa yokuthi i-hydroxocobalamin iyi-pigment ebomvu ye-burgundy emnyama kakhulu, ishintsha isikhumba , izinyembezi, umjuluko, nomchamo obomvu wewayini (chromaturia) ogqamile evikini elingu-1 kuya kwangu-2 ngemva kokwelashwa. Lokhu kuguquguquka kombala obomvu akunangozi ngokuphelele futhi kukhombisa ukuthi ikhambi liyazungeza.

I-Deep Dive 3: Izimo Eziphuthumayo Zokuxuba Isihlanzi Sekhaya (I-Bleach + Ammonia noma I-Acid)

Izinkulungwane zokuvakashelwa komnyango wezimo eziphuthumayo zenzeka minyaka yonke lapho othile ezama "ukuhlanza kakhulu" isitsha sendlu yangasese engcolile, indawo yokugezela, ibhokisi likadoti wekati, noma ipayipi elivalekile ngokuthela abahlanzi basekhaya ababili abahlukene ndawonye endlini encane, engenamoya:

  1. I-Sodium Hypochlorite Bleach + Ammonia (noma Umchamo endlini yangasese/ebhokisini lekati) \(\rightarrow\) Chloramine Gas (\(NH_2Cl\) and \(NCl_3\)): Ibangela ukuvutha kwamehlo anamanzi, ukukhwehlela okunobudlova, ukucasuka komphimbo, ukuqina kwesifuba, nokuhefuzela.
  2. I-Sodium Hypochlorite Bleach + Acid (Isihlanzi Sesitsha Sasendlu yangasese, i-Muriatic Acid, Vinegar, Lime/Rust Remover, noma i-Drain Opener) \(\rightarrow\) Igesi Ye-Chlorine Ehlanzekile (\(Cl_2\)): Ikhipha ifu elisindayo, eliphuzi-eliphuzi le-corrosive corrosive air and corrosive air chlorine chlorine umoya ovuzayo i-asidi** khona kanye emaphashini.
  3. Okufanele ukwenze ngokushesha uma uxube okokuhlanza endlini:
  4. Bamba umoya bese uphuma endlini yangasese/egunjini ngokushesha: ungahlali ngaphakathi ubambe umoya imizuzu emi-2 uzama ukukhuhla noma ukugeza indlu yangasese.
  5. Vula amafasitela neminyango yangaphandle ukuze unqamule indlu futhi uhambise wonke umuntu (nezilwane ezifuywayo) ngaphandle emoyeni omusha wangaphandle.
  6. Uma ukukhwehlela kwakho kuma phakathi nemizuzu emi-5 kuya kweyi-10 emoyeni omusha futhi ungenakho ukunqanyulwa komoya, ukuhefuzela, ubuhlungu besifuba, noma ukuhogela kwezwi, shayela Ukulawula Ubuthi (1-800-222-1222 e-US) ukuze uthole isiqondiso sokuqapha ekhaya.
  7. Yiya eMnyangweni Wezimo Eziphuthumayo noma ushayele ku-911/112/999 ngokushesha uma ukukhwehlela kuqhubeka, uma uzwa ikhwela/uhefuzela esifubeni sakho, uma unomlando isifuba somoya noma i-COPD, noma uma uzizwa uphelelwa umoya. Egunjini lezimo eziphuthumayo, ukuhogela i-albuterol ene-nebulized ebhangqwe ne- nebulized 2% kuya ku-3.75% sodium bicarbonate kunciphisa ngokushesha i-hydrochloric acid esihlahleni se-bronchial futhi kudambise ubuhlungu besifuba nokuhefuzela.

I-Deep Dive 4: "I-4-to-24-Hour Delayed Pulmonary Edema" Trap (Phosgene & Silo Gas)

Kungani abashiseli, oomakhenikha, nabalimi ngezinye izikhathi besuka ekuchayekeni kwegesi kancane bezizwa bekahle ngokuphelele ngo-2:00 PM, bese bebulawa ukuphefumula kanzima ngo-2:00 AM ngalobo busuku?

  • Umthetho Wokuncibilika Kwamanzi Wamagesi Acasulayo:
  • Amagesi ancibilika kakhulu emanzini (njenge-Amonia kanye ne-Sulfur Dioxide) ancibilika lapho nje ethinta ulwelwesi olumanzi lwamehlo akho, ikhala, nomphimbo. Ngoba zishisa ikhala lakho nomphimbo ngokushesha phakathi kwesekhondi elingu-1, zicupha i-alamu esheshayo ekuphoqa ukuba ubalekele ngaphambi kokuba igesi eningi ifinyelele emaphashini akho ajulile.
  • Amagesi ancibilikayo emanzini angalungile: ngokukhethekile I-Phosgene (\(COCl_2\)) (yakhiwa noma nini uma umakhenikha eshisela, ebhsa, noma esebenzisa i-blowtorch ezingxenyeni zensimbi ezisanda kufafazwa nge-chlorinated brake cleaner equkethe i-tetrachlorethylene noma i-methylene chloride) kanye **NO_2izinsuku ze-Nitrogen (1\() ngemva kokugcwalisa i-\) isisele sepulazi esinommbila omusha noma i-alfalfa silage): UNGAncibiliki ekhaleni elimanzi noma emphinjeni.
  • Ukubhujiswa Kwe-Alveolar Okuthulile: Ngenxa yokuthi i-phosgene ne-nitrogen dioxide ayicasuli ikhala noma umphimbo kakhulu emazingeni aphansi ukuya kwamaphakathi, isisebenzi sikuphefumulela ekujuleni kwe-microscopic alveoli ezansi kwamaphaphu ngaphandle kokukhwehlela kakhulu. Emahoreni angu-4 kuya kwangu-24* alandelayo, igesi i-hydrolyzes kancane kancane kulwelwesi lwe-alveolar-capillary ibe yi-hydrochloric noma i-nitric acid, ikhumule i-surfactant futhi ibangele ukuthi amaphaphu agcwale kungazelelwe uketshezi olunothe ngamaprotheni (ukulibaziseka kwe-non-cardiogenic pulmonary edema / ARDS). Noma ubani ohogela intuthu ye-phosgene (welding over brake cleaner) noma igesi ye-silo ensundu ngokuphuzi kufanele ahlale egadiwe esibhedlela okungenani amahora angu-12 kuya kwangu-24 ngaphandle kokuzikhandla ngokomzimba, ngisho noma ezizwa engasenazimpawu ngamaphesenti angu-100 ekuqaleni.

Imibuzo ejwayelekile ukubuzwa

Uma othile ewa phansi emgodini womgodi, ithangi le-septic, noma umgodi womquba wasepulazini, kungani ngingakwazi ukudonsa umoya, ngibambe umoya imizuzwana engu-30, bese ngehla ukuze ngixhume intambo kuwo?

Amaqiniso amathathu aphathekayo enza "ukubamba umoya" kube isigwebo sentambo endaweni evalekile: Okokuqala, ukuphakamisa umuntu omdala onesisindo esingamakhilogremu angu-80 (amakhilogremu angu-175) oqulekile ukhuphuke ngeladi eliqondile akunakwenzeka ngokomzimba ngenkathi ubambe umoya; phakathi nemizuzwana engu-15 yokuzikhandla okukhulu emgodini onomoya-mpilo omncane noma onobuthi, i-diaphragm reflex yobuchopho bakho ezenzakalelayo ikuphoqa ukuthi uhefuze. Okwesibili, ukuthatha umoya OWODWA nje owodwa we-Hydrogen Sulfide egxilile (> 700 kuya ku-1,000 ppm) noma u-0% we-oxygen nitrogen emkhathini kubangela ukulahlekelwa ukwazi ngokuphazima kweso ("i-knockdown") kumasekhondi angu-2 ukuya kwangu-3. Okwesithathu, amagesi anobuthi njenge-hydrogen sulfide ne-hydrogen cyanide nawo amunca emehlweni akho nasesikhunjeni esimanzi. Linda izicishamlilo ezigqoke amathangi e-SCBA anengcindezi evumayo kanye newintshi eyimishini emithathu.

Ngephutha ngaxuba i-bleach neviniga (noma i-bleach ne-ammonia) ngenkathi ngihlanza indlu yokugezela, ngakhwehlela izikhathi ezimbalwa njengoba ngiphumela ngaphandle, futhi manje ngemva kwemizuzu engu-20 ngisemoyeni ohlanzekile ngizizwa ngikahle ngokuphelele. Ingabe ngidinga ukuya kwa-ER?

Ngokungafani ne-phosgene noma i-nitrogen dioxide (enokuqala kokulibaziseka kwamahora angu-24), igesi ye-chlorine ne-chloramine evela ezixubeni ze-bleach yasendlini inokunyibilika kwamanzi okuphakathi nendawo kuya phezulu, okusho ukuthi abangela ukucasuka ngokushesha lapho uthintana. Uma uphumele emoyeni omusha ngokushesha, ukukhwehlela kwakho nokuluma kwamehlo kumile ngokuphelele phakathi kwemizuzu eyi-15 kuya kwengama-30, izwi lakho lijwayelekile, futhi ukuphefumula kwakho kuzwakala kucace 100%. Kodwa-ke, uma unokukhwehlela okungapheli, ukucinana kwesifuba, ukuhefuzela, ukuphelelwa umoya, noma isifuba somoya/i-COPD engaphansi, vakashela umnyango wezimo eziphuthumayo ngokushesha.

Kungani isitolo sikamakhenikha sasixwayisa ngokuthi UNGALINGE sisebenzise umshini wokuhlanza izingxenye zamabhuleki ensimbi esezoshiselwa?

Izihlanzi ezisindayo zamabhuleki ezimoto kanye nama-degreaser ensimbi aqukethe izinyibilikisi ze-hydrocarbon ezine-chlorine (njenge-tetrachlorethylene / perchlorethylene, trichlorethylene, noma i-methylene chloride). Ngisho noma insimbi ibonakala yomile ngemva kokufafaza, amanani amancane e-solvent ahlala evaleleke ezimbotsheni ezincane noma emithungweni yensimbi. Ngokuphazima kweso i-arc yokushisela ye-TIG/MIG kagesi noma ithoshi ye-oxyacetylene (noma ukukhanya kwe-ultraviolet okuvela ku-arc yokushisela) ishaya leso sincibilikiseli esine-chlorine esisele, sibola ngokufudumala sibe **Igesi ye-Phosgene ($COCl_2$)**: igesi ebulalayo ngqo yamakhemikhali esetshenziswa eMpini Yomhlaba wonke ingabangela ukubambezeleka okumbalwa. i-pulmonary edema amahora angu-6 kuya kwangu-24 kamuva. Ngaso sonke isikhathi sebenzisa isicoci sebhuleki esingena-chlorine kunoma iyiphi ingxenye ezoshiselwa noma eshiselwe.

Ingabe imaski yokuhlinza, isiphefumula sothuli esingu-N95, noma ithawula elimanzi eliboshwe ebusweni bami lingangivikela kugesi yendle, i-chlorine, i-ammonia, noma i-carbon monoxide?

Cha: zinikeza isivikelo esingu-ZERO kumagesi anobuthi noma ukuntuleka komoyampilo. Ama-respirators ezinhlayiya (njengamaski we-N95, KN95, noma i-P100) ahlunga kuphela izinhlayiya zothuli oluqinile namaconsi awuketshezi; ama-molecule egesi (njenge-$H_2S$, $HCN$, $CO$, $Cl_2$, kanye ne-$NH_3$) mancane ngokuphindwe ngezinkulungwane kunezimbotshana zokuhlunga futhi adlula ngqo kumaski we-N95 njengokungathi umnyango wesikrini. Ukwengeza, endaweni evalekile lapho umoya-mpilo ususwe khona ngaphansi kuka-19.5%, ngisho nemaski yegesi ye-cartridge yekhemikhali yemboni ayikwazi ukunikeza umoya-mpilo: i-Positive-Contained Breathing Apparatus (SCBA) kuphela enethangi layo lomoya elicindezelwe noma isiphefumulo sendiza esihlinzekiwe esingakugcina uphila.

Lo mhlahlandlela ngowezinjongo zokwaziswa futhi awuthathi indawo yokuhlolwa kwezokwelapha okuchwepheshile noma ukuqeqeshwa mathupha. Ngenxa yokuthi ukuhlenga igesi enobuthi kuvame ukudinga ukuvuselelwa ngokushesha kwenhliziyo yenhliziyo uma isisulu sesifike emoyeni omusha, sincoma ngokuqinile ukuthatha usizo lokuqala olugunyaziwe kanye nesifundo se-CPR nge-International Federation of Red Cross and Red Crescent Societies (IFRC), umphakathi wakho kazwelonke we-Red Cross, i-St John Ambulance, noma umhlinzeki wokuqeqesha wendawo.

Imithombo ihloliwe

  • I-National Institute for Occupational Safety and Health (NIOSH, United States) & Centers for Disease Control and Prevention (CDC): NIOSH Pocket Guide to Chemical Hazards (Hydrogen Sulfide, Hydrogen Cyanide, Chlorine, Ammonia, and Phosgene) kanye *Nokuvimbela Ukufa Kwabasebenzi Basemapulazini Emigodini Yomquba.
  • I-Ejensi Yokubhaliswa Kwezinto Ezinobuthi Nezifo (ATSDR, United States): Imihlahlandlela Yokuphathwa Kwezokwelapha ye-Hydrogen Sulfide (\(H_2S\)), i-Hydrogen Cyanide (\(HCN\)), i-Chlorine, i-Ammonia, ne-Phosgene.
  • Inhlangano Yezempilo Yomhlaba (i-WHO): Uhlelo Lwamazwe Ngamazwe Lokuphepha Kwamakhemikhali (i-IPCS): Ama-Monographs Olwazi Lobuthi kuma-Cyanides, i-Hydrogen Sulfide, kanye namaGasi Acasulayo.
  • I-UK Health Agency (UKHSA, United Kingdom): Inhlanganisela Yezingozi Zamakhemikhali: Ukulawulwa Kwezehlakalo kanye Ne-Toxicology ye-Hydrogen Cyanide, Hydrogen Sulfide, Chlorine, and Phosgene.
  • Ukulawulwa Kokuphepha Nezempilo Emsebenzini (OSHA, United States): Imvume-Edingekayo Yezikhala Ezivaliwe (29 CFR 1910.146) kanye Neshidi Leqiniso Le-Hydrogen Sulfide.

Iziqondiso ezihlobene