Cyanide poisoning by most of us is associated with spy movies or Agatha Christie's crime stories. Unfortunately, this deadly poison is constantly present in our lives, and most interestingly, in Poland you can even buy cyanide online. What are the symptoms of cyanide poisoning? is there an antidote? Is first aid effective? How is cyanide poisoning treated?
Cyanide poisoningis rare, but is violent and very often fatal. Victims of such poisonings usually die on the scene without receiving any medical help.
Cyanide lethal dose is 150-500 mg.
Cyanide poisoning is an extremely dangerous event, in which the fate of the injured person is determined by the quick administration of the antidote. Unfortunately, this is not always possible. Hence the very high mortality, estimated at 11 to 95%.
Cyanide poisoning: causes
The most common cause of poisoning is hydrogen cyanide, which is responsible for the most fatal poisoning in fires, but it is rarely mentioned.
We usually hear that the cause of deaths from fire victims was carbon monoxide poisoning. However, specialists believe that both of these substances are equally effective at taking the lives of victims.
Hydrogen cyanide is produced by pyrolysis (it is a process of degradation under the influence of high temperature and without oxygen) of wool, cotton, silk, nylon, polyurethane, rubber, polystyrene, paper and other products containing carbon and nitrogen. So, materials that are abundant in every home or business.
The highest concentrations of hydrogen cyanide arise when fire spreads over small and confined spaces. The rate of gas evolution depends on the temperature and the oxygen flow.
Cyanides are widely used in industry. They are used in the production of nylon, polyvinyl chloride, polyurethane foam, polyester, neoprene foam, rubber and other synthetics.
They are used in electroforming, for cleaning and hardening metals, in the pharmaceutical and photographic industries.
Cyanide: legal poison
In recent years, many experts have pointed out that cyanide can be used by terrorists because it hasenormous lethal potential, and its use does not require specialist knowledge. And worst of all, cyanide can be legally bought in Poland.
The Act of 1967 allowed only people with special permits to carry cyanide.
Cyanide sales to private individuals were banned in 2002.
This regulation was questioned in 2010 by the European Commission.
This is because EU law does not restrict the sale of this substance.
CuriosityYou cannot buy multiple bottles of pseudoephedrine cough syrup from the pharmacy, but you can legally buy cyanide. Using the Internet, you can acquire 1 g of cyanide overnight for just over 3,000. PLN.
Potassium cyanide: mechanism of action
The primary function of cyanides is by attaching them to the trivalent iron of cytochrome oxidase, which is a key enzyme in the respiratory chain.
This combination results in blocking intracellular respiration and an increase in the synthesis of lactic acid.
As a result, there is a strong hypoxia of cells and their death.
Cyanides also inhibit the activity of other enzymes, e.g.
- glutamate decarboxylase
- succinate dehydrogenzay
- katalazy
- peroxidase
- xanthine oxidase
- carbonic anhydrase
causing additional disturbances in cell metabolism.
It is reassuring that the combination of cyanide ions with cytochrome oxidase is reversible.
That is why time is of great importance for the future of the victims. The sooner the treatment, i.e. the administration of the antidote, is started, the greater the chances of the victim recovering from even severe poisoning.
Cyanide poisoning: what kind of substance, this reaction
The course of poisoning with cyanide ions depends on the structure of the parent compound from which they are released.
Hydrogen cyanide is a volatile liquid with a characteristic smell of bitter almonds. Symptoms of hydrogen cyanide poisoning appear almost immediately after exposure to this substance.
Highly soluble s alts in water (sodium cyanide, potassium cyanide, calcium cyanide, ammonium cyanide) cause symptoms very quickly, even after taking small doses.
Poisoning with hardly soluble s alts in water (cyanide and mercury oxyanide, copper cyanide, silver cyanide, cob alt cyanide and gold cyanide) occurs after ingestion of high doses of the substance.
The nitriles (e.g. acetonitrile) used as solvents act with a delay of several hours because cyanide ions are released from thethem only as a result of hepatic metabolism.
The tissues with the fastest oxygen metabolism, i.e. the brain and the heart, are the most sensitive to the toxic effects of cyanides, but hypoxia causes the dysfunction of all body cells.
Cyanide poisoning: mileage
The course of poisoning can be light, severe or electrifying, depending on the degree of exposure to the toxic compound.
Light poisoning causes light-headedness, dizziness, confusion, slight breathlessness.
When intoxication is severe, pain and sudden dizziness, confusion, loss of consciousness with respiratory disturbances and convulsions appear very quickly.
The electrifying cyanide poisoning leads to a sudden loss of consciousness, convulsions. Death occurs within minutes.
It is worth remembering that in case of cyanide poisoning, the skin of the injured person will not turn blue, despite cardio-respiratory failure.
This is because due to the inhibition of cellular oxygen metabolism, the blood becomes saturated with oxygen from the venous blood.
Cyanide poisoning: symptoms
Cyanide can be poisoned by swallowing this substance, inhaling toxic fumes or by contact with the skin.
Reactions to poisoning and symptoms depend not only on the dose taken, but also on the pH of the stomach and individual sensitivity.
When inhaled, it appears:
- headache
- tinnitus
- shortness of breath with a feeling of tightness in the chest
- vomiting
- acceleration and weakening of the heart rate
- lowering blood pressure
- coma
Less specific symptoms include:
- irritation of the mucous membranes
- feeling of a scratchy throat
- tongue baking
- conjunctivitis
- states of excitation
- heart arrhythmia
- pupil dilation
Later there is shortness of breath and fear of suffocation, respiratory rate increases significantly, consciousness is disturbed and unconsciousness occurs. There are also tonic-clonic convulsions. The skin is gray in color.
When to suspect cyanide poisoning
Unfortunately, there may be many such situations. We should always bear in mind that cyanide poisoning may be the cause of malaise, strange behavior or sudden loss of consciousness. Usually poisoning occurs when:
- the fire occurred in a closed room
- burned polyurethane foam, cotton, silk, wool, polystyrene or other plastics
- presence foundsoot in the nasal vestibule or mouth of the victim
- there were disturbances in consciousness (anxiety, agitation, slowness, confusion, coma)
- there were neurological symptoms, e.g. convulsions
- hypotension was found
- the pink color of the skin persists (even in patients with circulatory and respiratory insufficiency)
You should also think about cyanide poisoning when:
- an employee of a laboratory or industrial plant where cyano compounds are used or produced is suddenly unconscious
- there was an accident during the transport of hydrogen cyanide or other cyan compounds
- someone has drunk nail polish remover (acetonitrile) - watch out for small children and leave nail polish remover in easily accessible places
- Cyanogenic glycosides are found in the flesh of fruit kernels (apricot kernels - considered by some to cure cancer, peach, plum, cherries, apples, elderberries), there are many people who are in the habit of eating the flesh - with a large amount of seeds consumed, he alth problems may appear; in addition, cyanide also contains bitter almonds
- the patient is treated with high doses of sodium nitroprusside
- for suicide attempts involving coma, convulsions and lactic acidosis
Cyanide poisoning: how is it treated?
A person suspected of poisoning with cyanides should be moved or removed from the place contaminated with vapors as soon as possible, and then the basic activities of the body should be secured.
People who have lost consciousness must not be resuscitated using the mouth-to-mouth method, as this way the rescuer himself will be poisoned.
Immediately call an ambulance and inform the dispatcher of suspected cyanide poisoning.
If you get cyanide poisoning through ingestion of poison, do the same.
The casu alty is moved to a safe place and then we start providing first aid.
If the patient is conscious, we give him medicinal charcoal (even 10 tablets at a time), he can induce vomiting and give laxatives.
Contact a poison control center very quickly, where the patient can be given an antidote.
The main antidote in cyanide poisoning is hydroxocobalamin, which displaces cyanides from connections with chromium oxidase.
The victim must get oxygen. Its stream should flow quite quickly through the respiratory tract for ventilation to be as high as possible.
By other meanshelpful in the case of cyanide poisoning are sodium thiosulfate and compounds that form complexes with toxins that have entered the body.
The overall prognosis for people who have been poisoned is good, but the cases where the victims fall into a coma are dangerous.
Cyanide poisoning: before help arrives
You have to wait a few or several minutes (sometimes longer, unfortunately) for the arrival of the rescue team. But while waiting for the paramedics to arrive, you can do a lot of good for the victim.
If we have taken the patient out of the fire or from the place where cyanide has leaked, remove his clothes and pack them into two rubbish bags.
Skin should be rinsed with water or soap and water.
You also need to rinse your eyes and put on a dry, sterile dressing.
The injured person should not be active, i.e. he should not walk. It is best for him to stay in a quiet and safe place.
If we have the appropriate equipment, immediately put on the oxygen mask and set the device to fast gas flow.
Also read:
- Arsenic poisoning
- Poisoning with heavy metals
- Lead poisoning (lead)
- Silver poisoning
- Nicotine poisoning
- Alcohol poisoning
Anna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.
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