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Cyanide Poisoning

Cyanide poisoning is very rare, but frequently fatal, and is a potentially treatable cause of AMS. Routes of exposure include oral ingestion (often suicidal), cutaneous exposure (usually industrial), and inhalational (e.g., smoke from a fire).

Cyanide inhibits oxygen metabolism at the cellular level. The clinical appearance of these patients is therefore similar to those who are hypoxic, except that the blood of patients with cyanide poisoning is well oxygenated; therefore cyanosis does not appear until the onset of respiratory failure. Patients have a severe metabolic acidosis as a result of anaerobic cellular metabolism. An odor of almonds also may be detected.


  • Several factors that may cause cyanide poisoning such as includes Smoke inhalation( that contain many compounds such as nitrogen and carbon, it may produce hydrogen cyanide gas when burned), Natural compounds such as wool, silk may produce HCN as a combustion product.
  • Household plastics such as includes melamine in dishware, acrylonitrile in plastic cups, polyurethane foam in furniture cushions, and many other synthetic compounds that may produce lethal concentrations of cyanide when burned under appropriate conditions of oxygen concentration and temperature.
  • Common substances such as rubber can create cyanide fumes.


  • Rate of symptom development depends on form, concentration, and route of ingestion: inhalation (seconds to minutes), oral ingestion of cyanide salts (several minutes to 1 hour), organic cyanides (up to 12 hours ).
  • AMS: initial stimulation followed by a rapid loss of consciousness
  • Nausea and vomiting
  • Palpitations


  • AMS: agitation, confusion, coma
  • Seizures
  • Arrhythmias, asystole
  • Profound hypotension


  • Antidotal therapy is used to treat the cyanide poisoning. Amyl nitrite, sodium nitrite, and sodium thiosulfate with high-dose oxygen should be given as soon as possible.
  • You can also used antidote kit if a strong suspicion for cyanide poisoning exists. Because it consists of 3 medicines, in which one is held under the nose until the other 2 can be given intravenously. These antidotes can often prevent the cyanide from further poisoning the victim.

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