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Sds-Fire Pro Final
Sds-Fire Pro Final
Operators Manual P a g e | 15
HAZARDOUS SUBSTANCE. DANGEROUS GOODS. According to NOHSC Criteria, and ADG Code.
NOTES TO PHYSICIAN
Symptoms of vasodilation and reflex tachycardia may present following organic nitrate overdose;
most organic nitrates are extensively metabolised by hydrolysis to inorganic nitrites. Organic nitrates
and nitrites are readily absorbed through the skin, lungs, mucosa and gastro-intestinal tract.
The toxicity of nitrates and nitrites result from their vasodilating properties and their propensity to
form methaemoglobin.
• Most produce a peak effect within 30 minutes.
• Clinical signs of cyanosis appear before other symptoms because of the dark pigmentation of
methaemoglobin.
• Initial attention should be directed towards improving oxygen delivery, with assisted
ventilation, if necessary. Hyperbaric oxygen has not demonstrated conclusive benefits.
• Institute cardiac monitoring, especially in patients with coronary artery or pulmonary disease.
• Hypotension should respond to Trendelenburg's position and intravenous fluids; otherwise
dopamine may be needed.
• Naloxone, glucose and thiamine should be given if ingestion is suspected.
• Decontaminate using Ipecac Syrup for alert patients or lavage for obtunded patients who
present within 2-4 hours of ingestion.
• Symptomatic patients with methaemoglobin levels over 30% should receive methylene blue.
(Cyanosis alone is not an indication for treatment). The usual dose is 1-2 mg/kg of a 1%
solution (10 mg/ml) IV over 5 minutes; repeat, using the same dose if symptoms of hypoxia fail
to subside within 1 hour.
[Ellenhorn and Barceloux: Medical Toxicology]
BIOLOGICAL EXPOSURE INDEX - BEI
These represent the determinants observed in specimens collected from a healthy worker who has
been exposed at the Exposure Standard (ES or TLV):
Determinant 1 Index Sampling Time Comments
Methaemoglobin in blood 1.5% of haemoglobin During or end of shift B, NS, SQ