Speed in removing the patient from a contaminated atmosphere and in removing DMS from the skin or eyes is most important. To avoid serious injury, first aid must always be started immediately for contact with DMS in any form. For all affected persons, call a physician, even if there is no evidence of injury as effects can be delayed for more than 10 hours. Give the physician a detailed account of the accident.
Irritation by DMS may not be noted for several hours after exposure. Any worker exposed to DMS should be moved immediately to fresh air; call a physician.
The eyes should be flushed immediately with running water for at least 15 minutes. If oxygen is available with trained personnel to administer it, the patient should be given 100% oxygen (preferably exhaled against a positive pressure of not more than 6 cm [2-3/8 in] of water). Oxygen inhalation should be instituted, even if there are no signs of injury and should be carried on for 30 minutes of each hour for 6 hours.
If respiration is weak or fails, give artificial respiration or use oxygen inhalation through suitable equipment.
If excessive coughing due to the action of DMS upon the upper respiratory tract makes it difficult to use a mask, an oxygen tent should be used, giving the patient oxygen under atmospheric pressure.
Because the administration of oxygen should be continuous (1 hour maximum for continuous treatment with 100% oxygen), a small portable oxygen tank plus mask should be available for use during transfer of a patient from the plant to a hospital.
It may not be advisable to administer oxygen under positive pressure in the presence of impending or existing cardiovascular failure.
Remember that the action of DMS on the skin or eyes may be delayed for several hours after contact. First aid must be instituted as quickly as possible after contact. Flush the eyes with running water for at least 15 minutes. Remove all contaminated clothing immediately, including shoes. Destroy shoes. Wash contaminated clothing before reuse. Wash DMS off the skin under a shower with plenty of cool water for at least 15 minutes. Treat the affected areas at once with an ice water pack. Avoid freezing the skin. A solution of three parts rubbing alcohol to one part water may help relieve pain and the severity of the burn.
If liquid DMS has entered the eyes or if they have been exposed to strong concentrations of the vapor, they should be flushed immediately with plenty of water for at least 15 minutes. The eyes should be held open during the irrigation to ensure contact of water with all the tissues of the surface of the eye and lids.
Promptly call a physician, preferably an eye specialist. If a physician is not immediately available, the eye irrigation should be continued for a second period of 15 minutes. No oils or oily ointments should be instilled, unless ordered by the physician.
Ingestion of DMS is unlikely in industrial uses; however, should it occur, the following first aid measures should be undertaken. Dilute the DMS immediately by giving large quantities of milk of magnesia, aluminum hydroxide gel, milk or water to drink; beaten eggs may be given as a demulcent. Do not give a solution of baking soda. Contact a physician. DO NOT INDUCE VOMITING. NEVER GIVE ANYTHING BY MOUTH TO AN UNCONSCIOUS PERSON.
There is no specific antidote for the treatment of DMS intoxication. Effective treatments include the following:
Administration of oxygen
Nebulized bronchial dilator such as isoproterenol or epinephrine for bronchial spasm
In the more severe cases, intravenous hydrocortisone followed by oral steroid therapy such as prednisone for several days
Broad spectrum antibiotics if superimposed bacterial pneumonia is suspected
Nebulized nonirritant bronchial detergents to moisten the bronchial mucosa and increase mucous secretion
Tracheotomy as indicated
Because of the risk of delayed occurrence of pulmonary edema, the importance of careful observation of a patient thought to have inhaled DMS vapor cannot be overemphasized. The effects of DMS exposure could appear more than 10 hours after exposure.