casbrew.blogg.se - Cyanide treatment kit

Progressive features will result from end-organ damage secondary to anaerobic respiration and the build up of lactate e.g.

Milder exposures result in non-specific features including nausea, vomiting, headache, SOB, increased respiratory rate, hypertension, tachycardia, altered GCS and seizures.

Acute inhalation or ingestion will result in rapid LOC and seizures.

In the CNS cyanide triggers the release of NMDA which leads to seizures.

Biogenic amines are also released which result in pulmonary and coronary vasoconstriction.

Cyanide binds to ferric ion (Fe3+) of cytochrome oxidase and inhibits oxidative metabolism (essentially blocking the electron transport chain).

Chronic exposure can lead to non-specific symptoms similar to carbon monoxide exposure such as nausea, headache, fatigue, SOB, hypertension and even parkinsonism.

Caution is advised if the cyanide compound is acetonitrile (found in industry and nail salons), life-threatening toxicity can be delayed up to 24 hours later.Plant materials – usually seeds contain cyanogenic amygdalin which rarely causes symptoms however, there are case reports of people grinding up seeds for health drinks and developing toxicity (you need a lot of seeds).Patients that arrive post accidental ingestion or after an inhalation exposure survive with good supportive care.Death is likely to occur before arrival to hospital. Acute cyanide ingestion (50mg of hydrogen cyanide or 200mg of potassium cyanide) or inhalation of hydrogen cyanide gas can be rapidly lethal.In some parts of Europe it is common for the fire brigade to carry the cynokit and treat empirically if there is suspicion for cyanide toxicity. Cyanide is produced from melting plastics and those enclosed in house fires are at considerable risk. However, the most likely situation in your emergency department will be a house fire. Throughout history there have also been some popular examples including the mass suicide at Jonestown and Heaven’s gate, it was also commonly used by the Nazi’s including Hitler.

Cyanide toxicity is usually reserved for the spy movies whereby the villain will bite down on a capsule of cyanide and instantly froth at the mouth and die.