Cyanide Poisoning Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Cyanide poisoning is a condition when a person inhales gas or swallows cyanide above safe limits.
The media can vary, such as breathing air, consuming water or food, and touching soil that has been polluted by cyanide.
Actually, what is cyanide poison? Cyanide poison is a compound that has lethal properties and is known to cause death in a short time.
However, cyanide can actually refer to any chemical containing a carbon-nitrogen bond and can be found in trace amounts around us.
For example, traces of cyanide are found in many plant foods, including almonds, soybeans and spinach.
This substance generally occurs in colorless gases, for example, cyanogen chloride (CNCl) and hydrogen cyanide (HCN); and in the form of crystals, for example, sodium cyanide (NaCN) or potassium cyanide (KCN).
In addition, cyanide has been described as having a bitter almond odor, although it is often odorless and thus cannot be detected.
Cyanide Poisoning
| Medical specialist | Internal medicine specialist |
| Symptoms | Weakness, headache, nausea and vomiting, convulsions, shortness of breath, decreased consciousness |
| Risk factor | Industrial workers, farmers, photo film washers, metal processors |
| Diagnosis | medical interview, physical examination and supporting examination |
| Treatment | Stabilization of the airway and circulation, administration of drugs |
| Drug | antidotes (antidotes) hydroxocobalamin, sodium nitrite, sodium thiosulfate, seizure medications (lorazepam, midazolam, phenobarbital), epinephrine, sodium bicarbonate |
| Complications | Death, damage to the heart, nerves, and brain |
| When to see a doctor? | If suspected of exposure to or poisoning with cyanide and experiencing symptoms of cyanide poisoning |
Symptoms
Symptoms due to cyanide poisoning generally appear in a short time. The symptoms that appear depend on how much cyanide is exposed to a person’s body.
Some of the symptoms that can appear include:
- Limp all over the body to faint
- Headache
- Dizzy spinning or loss of balance
- Disturbances of consciousness, such as confused people
- seizures
- Abdominal pain
- Nausea and vomiting
- Hard to breathe
- Chest pain
If a person is exposed to high concentrations of cyanide gas, symptoms that may appear may include:
- Transient hyperpnea (increased breathing) and hypertension within 15 seconds of inhaling cyanide
- Seizures after 30-45 seconds of exposure to cyanide
- Loss of consciousness after 30 seconds of inhaling cyanide
- Stop breathing for 3-5 minutes after inhaling cyanide
- Bradycardia, hypotension, and cardiac arrest within 5-8 minutes after cyanide exposure
In addition to the above symptoms, cyanide poisoning can also cause skin discoloration to become reddish or known as cherry red color.
This can happen because a lot of oxygen is in the bloodstream, but can’t get into the cells of the body’s organs.
Reason
The cause of cyanide poisoning is exposure to dangerous amounts of cyanide poison when breathing air, consuming food or drink, and touching areas that already contain cyanide poison.
Cyanide will cause the body’s cells to lack oxygen. These toxins block and prevent the body’s cells from using oxygen. Ultimately, the effects of cyanide poisoning will cause these cells to die.
That is why, cyanide poison is more dangerous for the heart and brain than other organs. These two vital organs use a lot of oxygen.
Risk Factors
A person has the potential to experience cyanide poisoning if exposed to cyanide directly either by inhaling or ingesting the substance.
Several groups tend to be more at risk of experiencing cyanide poisoning, including:
- Industrial workers in paper, textile, plastic departments
- Photography that washes prints of photo film
- Metal processor
- Refinement of gold ore
- Agriculture
- Mining
- Chemical laboratory workers
- Smoker
- Accidentally ingesting a nail polish containing acetonitrile
Diagnosis
In making a diagnosis of cyanide poisoning, a specialist in internal medicine will conduct medical interviews as well as physical and supporting examinations.
Medical interviews can be conducted with other family members while helping victims of cyanide poisoning.
Medical interviews are conducted to find out the risk factors you have, such as work, activities carried out, and food or drink consumed.
After that, a physical examination will be carried out to determine the patient’s condition.
On physical examination, unstable vital signs (bradycardia, hypertension, arrhythmia, tachypnea) and reddish skin color can be found.
In addition, other signs that can be found are breath that smells like bitter almonds, there is soot in the mouth and nose when inhaling smoke, dilated pupils, and diaphoresis (excessive cold sweat).
Supporting examinations that the doctor will continue to include:
- General check-up
- Examination of body electrolytes
- Urinalysis
- Blood gas analysis
- Plasma lactate test
- Examination of methemoglobinemia levels
- Examination of carboxyhemoglobin levels
- Checking the cyanide level
- EKG
- X-ray data
Treatment
Considering that cyanide poison is a deadly compound, sufferers who experience cyanide poisoning need immediate help at a health facility.
Cyanide poisoning can cause death within 15 minutes or even less.
The first treatment that can be done for victims of cyanide poisoning includes:
- Immediately leave the room or away from the cyanide exposure
- If the victim’s clothing or body is contaminated with cyanide, remove it immediately and rinse it with water and soap
- Immediately take it to a health facility to get further help
In health facilities, the doctor will give an antidote to help treat cyanide poisoning.
In addition, doctors must also ensure that the victim’s airway, breathing and blood circulation remain stable.
Giving a single dose of 50 g of activated charcoal in adults or 1g/kg BW in children can be given immediately to help absorb toxins.
Cyanide antidotes should be given immediately if no contraindications exist. The choices of cyanide antidotes that can be given are:
1. Hydroxocobalamin
It is the first-line drug of choice used to treat poisoning or suspected cyanide poisoning.
This drug works by binding to cyanide in the body to form cyanocobalamin (vitamin B12) and excreted through the kidneys.
2. Sodium Nitrite and Sodium Thiosulfate
Sodium nitrite and sodium thiosulfate are also often used in combination to treat cyanide poisoning. These two drugs are the second line after hydroxocobalamin.
Sodium nitrite can work quickly and effectively, but the side effects that may arise are toxicity which can be life-threatening.
Meanwhile, sodium thiosulfate works slower, but safer.
Sodium nitrite causes methemoglobin in red blood cells which binds to cyanide releasing the enzyme cytochrome oxidase.
Meanwhile, sodium thiosulphate provides sulfur atoms to convert cyanide into thiocyanate thereby increasing the detoxification system. Later, thiocyanate will be excreted through the kidneys.
Other drugs can also be given and adjusted to the patient’s condition, such as:
- Sodium bicarbonate, which is used to treat lactic acidosis
- Epinephrine, which can help improve the work of the heart and blood vessels in distributing oxygen throughout the body
- Anticonvulsants, such as lorazepam, midazolam, and phenobarbital, can be used when patients experience seizures
Prevention
Although cyanide poisoning can happen to anyone and cannot always be prevented, there are several things that can be done to reduce the risk of cyanide poisoning, such as:
- Follow work safety regulations at work, try to always wear personal protective equipment
- Store chemicals in a safe and locked place. Don’t forget to label the chemical packaging
- Preventing fires, one of which is by installing smoke detectors
- Avoid burning plastic
- Wash and process food properly
Complications
When a person experiences mild symptoms and the amount of exposure to cyanide is small, they will generally recover and recover as usual without any complications.
On the other hand, when the symptoms experienced are severe and exposed in large amounts, cyanide poisoning can cause damage to the heart, nerves, and brain organs, and even death.
That is why medical assistance must be given immediately to patients with indications of cyanide poisoning.
When to See a Doctor?
Immediately go to the doctor or the nearest health facility if symptoms of cyanide poisoning appear as described above.
In addition, people suspected of being exposed to cyanide, either ingesting or inhaling cyanide, should also see a doctor.