Cyanides are the salts of hydrocyanic acid and are among the most poisonous substances known. It has a characteristic of ‘bitter almond’ smell. Cyanide poisoning occurs mainly from breathing hydrogen cyanide gas or cyanide dust but can also occur by absorption through the skin following contact with solutions of cyanide salts or even with hydrogen cyanide in the air. Cyanide can induce a life-threatening poisoning.1 Such poisoning is a medical emergency that requires prompt recognition and immediate treatment.
Cyanide poisoning presents in many forms. Industrial intoxications occur due to use of cyanide compounds as reaction products. Smoke inhalation from residential fires is often responsible for domestic cyanide poisonings. Suicidal poisonings are rare.
Cyanide poisoning deprives oxygen to the cells in the body, particularly that of the heart and brain, resulting in CNS and cardiovascular dysfunction. Symptoms of mild-to-moderate poisoning include general weakness, headaches, dizziness, unsteadiness, a feeling of suffocation, nausea, rapid heart rate, difficulty in breathing, skin irritation and irritation in nose and throat. Exposure to high concentrations of the chemical can result in death within seconds to minutes. Survivors of significant poisonings can have long-term neurologic dysfunction.2
First aid procedures for cyanide poisoning are as follows and these should be done with utmost speed:
.Hospital treatment for significant poisonings includes aggressive supportive care and administration of antidotes such as sodium nitrite, sodium thiosulfate and hydroxocobalamin.3
1.Baud FJ. Cyanide: Critical issues in diagnosis and treatment. Hum Exp Toxicol. 2007; 26(3): 191–201.
2.Morocco AP. Cyanides. Crit Care Clin. 2005; 21(4): 691–705.
3.Mannaioni G, Vannacci A, Marzocca C, et al. Acute cyanide intoxication treated with a combination of hydroxycobalamin, sodium nitrite, and sodium thiosulfate. J Toxicol Clin Toxicol. 2002; 40(2): 181–183.
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