Definition

What is cyanide poisoning?

Cyanide is a rare, but potentially deadly poison. It works by making the body unable to use life-sustaining oxygen. Cyanide compounds that can be poisonous include hydrogen cyanide gas, and the crystalline solids, potassium cyanide and sodium cyanide.

How common is cyanide poisoning?

Please discuss with your doctor for further information.

 

Symptoms

What are the symptoms of cyanide poisoning?

Detection of cyanide poisoning can be difficult. The effects of cyanide ingestion are very similar to the effects of suffocation. The mechanism of toxicity occurs because cyanide stops the cells of the body from being able to use oxygen, which all cells need to survive.

The symptoms of cyanide poisoning are similar to those experienced when hiking or climbing at high altitudes, and include:

  • General weakness
  • Confusion
  • Bizarre behavior
  • Excessive sleepiness
  • Coma
  • Shortness of breath
  • Headache
  • Dizziness
  • Vomiting
  • Abdominal pain
  • Seizures

Typically, acute cyanide ingestion will have a dramatic, rapid onset, immediately affecting the heart and causing sudden collapse. It also can immediately affect the brain and cause a seizure or coma.

Chronic cyanide poisoning (over a long period of time) from ingestion or environmental poisoning will have a more gradual onset, and symptoms may include:

  • Headache
  • Changes in taste
  • Vomiting
  • Chest pain
  • Abdominal pain
  • Anxiety

The skin of a cyanide-poisoned person can sometimes be unusually pink or cherry-red because oxygen will stay in the blood and not get into the cells. The person may also breathe very fast and have either a very fast or very slow heartbeat. Sometimes the person’s breath can smell like bitter almonds, though this can be difficult to detect.

Perhaps most important is the environment, rather than the signs or symptoms.

A person who works in a laboratory or plastics factory has a higher risk of cyanide poisoning.

Home, RV, boat, or building fires always include the additional concern of cyanide exposure.

If you know someone has been depressed or has substance abuse problems and you find him or her with any of the signs or symptoms of cyanide poisoning, then a suicide attempt is possible. The setting may be more of a clue to whether a person has experienced cyanide poisoning than the symptoms.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or someone you know has ingested, inhaled or been exposed to cyanide, and you or they have signs or symptoms, such as weakness, dizziness, trouble breathing, confusion, or seizure, you must immediately call an ambulance, the emergency response system in your area, or a poison control center

Causes

What causes cyanide poisoning?

Cyanide poisoning is caused by:

  • Fires: Smoke inhalation during the burning of common substances such as rubber, plastic, and silk can create cyanide fumes and cause cyanide poisoning.
  • Photography, chemical research, synthetic plastics and fibers, metal processing, fumigation and pesticides, mining, and electroplating industries use hydrogen cyanide. Potassium cyanide is used in gold and silver extraction, chemical analysis, to make other chemicals, and as an insecticide.
  • Plants: Mostly from the family Rosaceae, seeds and pits from plants such as apricot, bitter almond, cherry laurel, plum, peach, pear, and apple contain cyanogenic glycosides. A type of potato called cassava can also cause cyanide poisoning. Fortunately, only chronic or massive ingestion of any of these plants or pits can cause serious cyanide poisoning.
  • Laetrile, a compound that contains amygdalin (a chemical found in the pits of raw fruits, nuts, and plants) has been purported as a cancer treatment worldwide. One of the side effects of laetrile is cyanide poisoning. The Food and Drug Administration (FDA) has not approved laetrile as a cancer treatment in the United States. The drug is also made and used as a cancer treatment in Mexico under the name “laetrile/amygdalin.”
  • Certain chemicals, after ingestion, can be converted by the body into cyanide and cause cyanide poisoning. Most of these chemicals have been removed from the market, but some old artificial nail polish removers, solvents, and plastics manufacturing solutions can contain these substances.
  • Cigarette smoke is the most common source of cyanide exposure for most people. Cyanide is naturally found in tobacco, and smokers can have more than 2.5 times the mean whole blood cyanide level of nonsmokers, though this is generally not enough to cause poisoning.

Risk factors

What increases my risk for cyanide poisoning?

There are many risk factors for cyanide poisoning, such as:

  • Those who work in industries that use this chemical and people who intentionally try to kill themselves.
  • Those who attempt suicide by using cyanide pills or capsules may believe it is a quick and painless death, however, cyanide burns the stomach and prevents the body from using oxygen, causing a painful death.
  • For most people, cyanide only causes poisoning if a fire occurs or if some of the compounds mentioned above are accidentally ingested.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is cyanide poisoning diagnosed?

Cyanide poisoning is a treatable condition, and it can be cured if detected quickly and treatment is started immediately. Most people die because the diagnosis is not made quickly enough, or it is not considered from the start. Cyanide poisoning is rare, so the treating physician should be alerted of the possibility. This may be one of the most important things you can do to help the victim.

If you are the rescuer, you will be asked questions about what happened to the victim. You will be asked if there were any bottles lying around, if the victim had any medical or psychiatric problems, and other details. Stay calm and answer the questions, because this is vital information necessary to care for the injured person.

Blood tests, X-rays, and other procedures will be necessary to try to determine if cyanide poisoning has occurred, how bad the poisoning is, or if some other type of poisoning has occurred.

The diagnostic test to detect cyanide takes hours to days to perform. Thus, the doctors will rely on a combination of what you tell them, what the victim looks like, and supporting laboratory data to decide the likelihood of actual cyanide exposure.

How is cyanide poisoning treated?

Depending on how sick the patient is, treatment will vary.

  • If the patient is completely unconscious, all attempts will be made to save the person’s life. A variety of invasive measures may need to be performed on the patient in order to closely monitor and evaluate the person.
  • If the patient’s condition is not grave, he or she will need a thorough investigation. Typically, the patient’s clothes will be removed because leftover cyanide on clothing can continue to poison both the patient and those providing care.
  • A Cyanide Antidote Kit (CAK) or Hydroxocobalamin (Cyanokit) may be may be used if a strong suspicion for cyanide poisoning exists. Although not a 100% successful cure, these antidotes can often prevent the cyanide from further poisoning the victim.
  • Dicobalt edetate is an intravenous chelator of cyanide (helps remove cyanide from the body), with a used in the United Kingdom. It is can have severe side effects including seizures, anaphylaxis, low blood pressure, and abnormal heartbeat. It is used only when a diagnosis of cyanide poisoning is nearly certain and alternative treatments are unavailable.
  • If the person has carbon monoxide poisoning as well, hyperbaric oxygen therapy may be used if available. This requires placing the person in a special chamber that will give an extremely high amount of oxygen.

Usually the local poison control center or poison specialist (toxicologist) will be notified about the victim. Their assistance will help to determine the patient’s care.

If it is determined that the risk of actual cyanide ingestion is very low, the patient may be monitored for a few hours. If the patient appears well enough, he or she may be sent home with careful instructions to return immediately if any of the previous signs or symptoms develop.

If a patient has had a significant cyanide exposure, has preexisting illnesses, or has an uncertain diagnosis and is too ill to go home, they will be admitted to the hospital for further treatment and observation.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage cyanide poisoning?

Cyanide poisoning cannot be treated at home. Immediate medical attention is always required.

If you have any questions, please consult with your doctor to better understand the best solution for you.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: October 24, 2017 | Last Modified: October 24, 2017

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