Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
권호 표지
DOI QR코드

DOI QR Code

Attempted Suicide by Nitrogen Gas Asphyxiation: A Case Report

질소 가스를 사용한 자살 시도 1례: 증례보고

  • Park, Sung-Wook (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Yeom, Seok-Ran (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Han, Sang-kyoon (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Kim, Hyung-Bin (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Cho, Young-Mo (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Bae, Byung-Kwan (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Wang, Il-Jae (Department of Emergency Medicine, Pusan National University Hospital)
  • 박성욱 (부산대학교 의학전문대학원 응급의학교실) ;
  • 염석란 (부산대학교 의학전문대학원 응급의학교실) ;
  • 한상균 (부산대학교 의학전문대학원 응급의학교실) ;
  • 김형빈 (부산대학교 의학전문대학원 응급의학교실) ;
  • 조영모 (부산대학교 의학전문대학원 응급의학교실) ;
  • 배병관 (부산대학교 의학전문대학원 응급의학교실) ;
  • 왕일재 (부산대학교 의학전문대학원 응급의학교실)
  • Received : 2017.06.05
  • Accepted : 2017.06.19
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Nitrogen is an inert gas that is harmless to humans under normal conditions. While it is not inherently toxic, nitrogen gas becomes dangerous when it displaces oxygen, resulting in suffocation. Herein, we report a case of a 34-year-old man who attempted suicide by nitrogen asphyxiation who presenting with decreased mental function and agitation. Lactic acidosis and hyperammonemia were observed on presentation at the emergency department, but these improved after a few hours. After 2 days, the patient regained full consciousness, and was discharged without any complications. Survival after asphyxiation due to nitrogen gas is very rare, and these patients are more likely to have poorer outcomes. There is a potential for the increasing use of nitrogen gas as a method of committing suicide because of the ease of access to this gas.

Keywords

References

  1. Weller MA. Asphyxia with nitrogen. Brit Med J 1959;1(5121):559. https://doi.org/10.1136/bmj.1.5121.559
  2. Harding BE, Wolf BC. Case report of suicide by inhalation of nitrogen gas. Am J Foren Med Path 2008;29(3):235-7. https://doi.org/10.1097/PAF.0b013e318183240c
  3. Rockswold G, Buran DJ. Inhalation of liquid nitrogen vapor. Ann Emerg Med 1982;11(10):553-5. https://doi.org/10.1016/S0196-0644(82)80430-7
  4. Kim DH, Lee HJ. Evaporated liquid nitrogen-induced asphyxia: a case report. J Korean Med Sci 2008;23(1):163-5. https://doi.org/10.3346/jkms.2008.23.1.163
  5. Gill JR, Ely SF, Hua Z. Environmental gas displacement: three accidental deaths in the workplace. Am J Foren Med Path 2002;23(1):26-30. https://doi.org/10.1097/00000433-200203000-00005
  6. Madentzoglou MS, Kastanaki AE, Nathena D, Kranioti EF, Michalodimitrakis M. Nitrogen-Plastic Bag Suicide: A Case Report. Am J Foren Med Path 2013;34(4):311-4. https://doi.org/10.1097/PAF.0000000000000049
  7. Auwarter V, Pragst F, Strauch H. Analytical investigations in a death case by suffocation in an argon atmosphere. Forensic Sci Int 2004;143(2):169-75. https://doi.org/10.1016/j.forsciint.2004.02.043
  8. Straka L, Novomesky F, Gavel A, Mlynar J, Hejna P. Suicidal Nitrogen Inhalation by use of Scuba Full-Face Diving Mask. J Forensic Sci 2013;58(5):1384-7. https://doi.org/10.1111/1556-4029.12239
  9. Yanisko P, Croll D. Use nitrogen safely. Chemical Engineering Progress 2012;108(3):44-8.
  10. Watanabe T, Morita M. Asphyxia due to oxygen deficiency by gaseous substances. Forensic Sci Int 1998;96(1):47-59. https://doi.org/10.1016/S0379-0738(98)00112-1
  11. Miller K, Chang A. Acute inhalation injury. Emerg Med Clin North Am 2003;21(2):533-57. https://doi.org/10.1016/S0733-8627(03)00011-7
  12. Tur F, Aksay E. Asphyxia due to accidental nitrogen gas inhalation: a case report. Hong Kong J Emerg Med 2012;19(1):46. https://doi.org/10.1177/102490791201900108
  13. Matz O, Zdebik C, Zechbauer S, Bundgens L, Litmathe J, Willmes K, et al. Lactate as a diagnostic marker in transient loss of consciousness. Seizure 2016;40:71-5. https://doi.org/10.1016/j.seizure.2016.06.014
  14. Tomita K, Otani N, Omata F, Ishimatsu S. Clinical significance of plasma ammonia in patients with generalized convulsion. Intern Med 2011;50(20):2297-301. https://doi.org/10.2169/internalmedicine.50.5950
  15. Hung TY, Chen CC, Wang TL, Su CF, Wang RF. Transient hyperammonemia n seizures: a prospective study. Epilepsia 2011;52(11):2043-9. https://doi.org/10.1111/j.1528-1167.2011.03279.x
  16. Andersen LW, Mackenhauer J, Roberts JC, Berg KM, Cocchi MN, Donnino MW. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin Proc 2013;88:1127-40. https://doi.org/10.1016/j.mayocp.2013.06.012
  17. Simon RP. Heart and lung in the postictal state. Epilepsy Behav 2010;19(2):167-71. https://doi.org/10.1016/j.yebeh.2010.06.025
  18. Gallagher KE, Smith DM, Mellen PF. Suicidal asphyxiation by using pure helium gas: case report, review, and discussion of the influence of the internet. Am J Foren Med Path 2003;24(4):361. https://doi.org/10.1097/01.paf.0000097856.31249.ac