Cyanide reversibly binds to the ferric ions cytochrome oxidase three within the mitochondria. This is due to the first two routes providing fast diffusion into the bloodstream. The toxicity of cyanide is linked mainly to the cessation of aerobic cell metabolism. Intravenous and inhalation of cyanide produce a more rapid onset of signs and symptoms than exposure via the oral or transdermal route. According to the National Poison Data System of a Poison Control Centers annual report, there were 247 reported cases of chemical exposures to cyanide in the United States in 2007, five of which were fatal. Approximately 35% of all fire victims will have toxic levels of cyanide in their blood on presentation for medical treatment. Fire is the most common source of cyanide exposure in industrialized countries such as the United States. EpidemiologyĪccording to the Toxic Exposure Surveillance System, there were 3165 human exposures to cyanide from 1993 to 2002. Toxic levels of cyanide may be present in patients who receive prolonged infusions of sodium nitroprusside. Sodium nitroprusside, a medication used to treat a hypertensive emergency, contains five cyanide groups per molecule. Cyanide also is used in a number of industrial applications such as electroplating injury production, photography, plastics and rubber manufacturing, and pesticides. In domestic countries, the most common cause of cyanide poisoning is domestic fires. EtiologyĬyanide poisoning may result from a variety of exposures, including structural fires, industrial exposures, medical exposures such as sodium nitroprusside, and certain foods. During World War II, the Nazis used cyanide as an agent of genocide in gas chambers. It has been used as a poison in mass homicides and suicides. Cyanide is also found in manufacturing and industrial sources such as insecticides, photographic solutions, and jewelry cleaners. Natural substances in some foods such as lima beans, almonds can release cyanide. Cyanide can exist as a gas, hydrogen cyanide, a salt, potassium cyanide. Hydrogen cyanide was first isolated from Prussian blue dye in 1786, and cyanide first extracted from almonds around 1800. Review interprofessional team strategies for improving care coordination and communication to improve outcomes with the management of cyanide toxicity.Ĭyanide is a rapidly acting substance that is traditionally known as a poison.Summarize the treatment and management strategy for cyanide toxicity.Outline the examination and evaluation procedures for diagnosing cyanide toxicity, including any applicable laboratory testing.Describe the basic pathophysiology and toxicokinetics of cyanide toxicity.This activity reviews the etiology, presentation, evaluation, and management/prevention of cyanide toxicity, and reviews the role of the interprofessional team in evaluating, diagnosing, and managing the condition. Cyanide is also found in manufacturing and industrial sources such as insecticides, photographic solutions, plastics manufacturing, and jewelry cleaner. Hydrogen cyanide was first isolated from Prussian blue dye in 1786 and cyanide first extracted from almonds around 1800. Cyanide is a rapidly acting substance that is traditionally known as a poison.
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