Acute cyanide poisoning is relatively rare , and the majority of cases are from unintentional exposure. If you suspect that you or a loved one is experiencing acute cyanide poisoning, seek immediate emergency medical attention.
This condition is life-threatening. Cyanide poisoning is rare. You may be at risk for accidental exposure if you work in certain fields. Many inorganic cyanide salts are used in the following industries:. After discussing your symptoms, your doctor will perform a physical exam. The first step to treating a suspected case of cyanide poisoning is to identify the source of exposure. This will help your doctor or other healthcare provider determine the appropriate decontamination method.
In the case of a fire or other emergency incident, rescue personnel will use protective gear like face masks, eye shields, and double gloves to enter the area and take you to a safe location.
If you have ingested cyanide, you may be given activated charcoal to help absorb the toxin and safely clear it from your body. Cyanide exposure can affect oxygen intake, so your doctor may administer percent oxygen via a mask or endotracheal tube. The cyanide antidote kit consists of three medications given together: amyl nitrite, sodium nitrite, and sodium thiosulfate.
The amyl nitrite is given by inhalation for 15 to 30 seconds, while sodium nitrite is administered intravenously over three to five minutes. Intravenous sodium thiosulfate is administered for about 30 minutes. Hydroxocobalamin will detoxify cyanide by binding with it to produce nontoxic vitamin B Our publications keep professionals working across the public, private, and academic sectors informed on the most important developments and issues in health security and biosecurity.
Fact sheet as PDF. Cyanide is a naturally occurring chemical, found in many plants, that has been used in conventional warfare and poisoning for 2 millennia. It is highly lethal, whether inhaled as a gas, ingested in solid form, or absorbed through topical exposure. Two notorious incidents in recent history-the Jonestown Massacre in and the Tylenol poisonings in highlight the lethality of this poison. First isolated in , cyanide is a compound composed of carbon triple bonded to nitrogen CN.
Cyanide can be released from natural sources, including some foods, and it is contained in several industrial chemicals and in cigarette smoke. It is also used in manufacturing and in pesticides. In medicine, cyanide can be found in the widely used anti-hypertensive, sodium nitroprusside, each molecule of which contains 5 molecules of cyanide.
The most common cause of cyanide poisoning is smoke inhalation in fires. The use of cyanide in warfare dates to the Franco-Prussian War , during which Napoleon III urged his troops to dip their bayonet tips in the poison.
Roman Emperor Nero also used cyanide-containing cherry laurel water as a poison. This poisonous compound poses an ongoing threat as a weapon of terrorism, whether it is delivered in oral form via sodium cyanide and potassium cyanide or as a gas via hydrogen cyanide and cyanogen chloride.
Cyanide poisons the mitochondrial electron transport chain within cells and renders the body unable to derive energy adenosine triphosphate-ATP from oxygen.
For more information on sheltering in place during a chemical emergency, see Facts About Sheltering in Place. If you think you may have been exposed to cyanide, you should remove your clothing, rapidly wash your entire body with soap and water, and get medical care as quickly as possible. Removing your clothing: Quickly take off clothing that may have cyanide on it.
Any clothing that has to be pulled over the head should be cut off the body instead of pulled over the head. If you are helping other people remove their clothing, try to avoid touching any contaminated areas, and remove the clothing as quickly as possible.
Washing yourself: As quickly as possible, wash any cyanide from your skin with large amounts of soap and water. Washing with soap and water will help protect people from any chemicals on their bodies.
If your eyes are burning or your vision is blurred, rinse your eyes with plain water for 10 to 15 minutes. If you wear contacts, remove them and put them with the contaminated clothing. Do not put the contacts back in your eyes even if they are not disposable contacts.
If you wear eyeglasses, wash them with soap and water. You can put your eyeglasses back on after you wash them. If you are wearing jewelry that you can wash with soap and water, you can wash it and put it back on. If it cannot be washed, it should be put with the contaminated clothing.
Disposing of your clothes: After you have washed yourself, place your clothing inside a plastic bag. Avoid touching contaminated areas of the clothing. An alternative method is to put the clothes in the bag using tongs, tool handles, sticks, or similar objects. Anything that touches the contaminated clothing should also be placed in the bag.
If you wear contacts, put them in the plastic bag, too. Breathing cyanide gas, especially in a poorly ventilated space, has the greatest potential for harm. Lethal exposures to cyanides result only from accidents or intentional acts. Because of their quick-acting nature, cyanides may be used as agents of terrorism. After exposure, cyanide quickly enters the bloodstream. The body handles small amounts of cyanide differently than large amounts. In small doses, cyanide in the body can be changed into thiocyanate, which is less harmful and is excreted in urine.
In the body, cyanide in small amounts can also combine with another chemical to form vitamin B 12 , which helps maintain healthy nerve and red blood cells.
Large doses of cyanide prevent cells from using oxygen and eventually these cells die. The heart, respiratory system and central nervous system are most susceptible to cyanide poisoning. The health effects from high levels of cyanide exposure can begin in seconds to minutes.
Some signs and symptoms of such exposures are:. The severity of health effects depends upon the route and duration of exposure, the dose, and the form of cyanide. Moving away from the point of exposure to fresh air is an important first step in treating cyanide exposure. Cyanide poisoning can be further treated by medical professionals. Often patients are given oxygen. Two antidotes sodium nitrite and sodium thiosulfate are usually used to stop the effects of serious cyanide poisoning.
Other drugs may be necessary to control additional health effects of cyanide such as seizures. People who experience serious signs and symptoms will need immediate hospital care, especially individuals who have "passed out" or are unconscious. Any delay could result in death.
While an elevated blood cyanide concentration may indicate that someone has been exposed to cyanide, laboratory testing for cyanide exposure will not be useful in making emergency treatment decisions.
A patient exposed to cyanide should not expect medical personnel to do these tests before treatment.
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