Cyanide Poisoning

Cyanide Poisoning 

Cyanide is a rare but potentially deadly poison. It works by making the body unable to use life-sustaining oxygen.

Common possible cause of poisoning is Fire. Smoke inhalation during the burning of common substances such as rubber, plastic, and silk can create cyanide fumes.

Cyanide compounds are used:

  • as fumigant rodenticide
  • in chemical industry
  • used in photography, metallurgy, electroplating, metal cleaning, ore refining, in the synthetic rubber industry, artificial nail removers, and rodenticides

Mechanism of action of cyanide in the body

Cyanide inhibits mitochondrial cytochrome oxidase and hence blocks electron transport, resulting in decreased oxidative metabolism and oxygen utilization. Lactic acidosis occurs as a consequence of anaerobic metabolism. The oxygen metabolism at the cell level is grossly hampered.

Cyanide is rapidly absorbed from the stomach, lungs, mucosal surfaces, and unbroken skin.

Cyanide poisoning can be difficult to detect. The effects of cyanide ingestion are very similar to the effects of suffocation.

The lethal dose of potassium or sodium cyanide is 200 to 300 mg and of hydrocyanic acid is 50 mg. Effects begin within seconds of inhalation and within 30 min of ingestion.

Initial effects of poisoning – include headache, faintness, vertigo, excitement, anxiety, a burning sensation in the mouth and throat, breathing difficulty, increased heart rate, and hypertension. Nausea, vomiting, and sweating are common. A bitter almond odor may be detected on the breath.

Later effects – include coma, convulsions, paralysis, respiratory depression, pulmonary edema, arrhythmias, bradycardia, and hypotension.

Treatment

Antidotal therapy: Amyl nitrite, sodium nitrite, and sodium thiosulfate (the Lilly cyanide antidote kit) with high-dose oxygen should be given as soon as possible.

The rationale for nitrite therapy is that the Nitrites cause formation of Methemoglobin by combining with the hemoglobin. Methemoglobin  has a higher affinity for cyanide than does cytochrome oxidase and thus promotes its dissociation from this enzyme. Thiosulfate reacts with the cyanide as the latter is slowly released from cyanomethemoglobin, forming the relatively nontoxic thiocyanate, which is excreted in the urine.
Amyl nitrite is administered for 30 sec. of each minute. The ampule is broken between two pads of gauze and placed over the airway while the patient breathes spontaneously or is ventilated by a bag-mask unit. A new ampule should be used every 3 min.

Sodium nitrite is administered intravenously as a 3% solution at a rate of 2.5 to 5.0 mL/min up to a total dose of 10 to 15 mL (300 to 450 mg). Sodium thiosulfate is then administered intravenously as a 25% solution at a dose of 50 mL (12.5 g) given over 1 to 2 min.

High dose oxygen is also given.

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About Manbir & Gurpreet

Gurpreet Kaur’s journey in this world .... Gurpreet Kaur was a Musician. She was a singer and a composer of music. Her interest was composing and singing Gurbani Shabads in Indian Classical style. She sang Shabads in All the Raags mentioned in Sri Guru Granth Sahib Ji. She also taught Gurmat Sangeet at Gurmat Gian Missionary College, Jawadi, Ludhiana. Elder child to Pushpinder Kaur and Dr. Brig. Harminder Singh, was born in Amritsar on 13th Jan 1962. She attended various convent schools as a child because her father would get frequent Army postings as a dental surgeon. She graduated with Music Honors from Govt. College for Women, Chandigarh. Music was her hobby and she composed and sang Raag based Gurbani Shabads. Doing Kirtan was part of growing up nurtured by her parents. She learned music from her father Dr. Brigadier Harminder Singh who was a dental surgeon in Indian Army and a very good singer himself. Gurpreet’s Bhua (father’s sister), Ajit Kaur retied as a Head of Department of Music from Govt. College for Women Ludhiana, and was a renounced Punjabi singer of her time. Gurpreet Kaur also learned nuances of Indian Classical Music from Pandita Sharma. She was a mother of three children, and a grandmother. Her daughter Keerat Kaur is a Computer Engineer. Her two sons Gurkeerat Singh and Jaskeerat Singh are doctors in USA. Her daughter Keerat Kaur too was part of her group ~ Gurmat Gian Group. Gurpreet Kaur left this world at the age of 54yrs on 12th Sept 2016 in Baltimore USA. She had recorded around 25 cds of Gurbani Keertan. 'Raag Ratan' Album (6 CDs) is a Compilation of Shabads in All the 31 Sudh Raags of Sri Guru Granth Sahib Ji. 'Gauri Sagar' Album (3 CDs) is a Compilation of All forms of Raag Gauri in Sri Guru Granth Sahib Ji. 'Nanak Ki Malhaar' ~ ((3 CDs) is an album of Raag Malhar Shabads in various forms of Malhar. 'Gur Parsaad Basant Bana' ~ (3 CDs) is an album of Shabads in Raag Basant sung in various forms of Raag Basant. Har Ki Vadeyai Sarni Aayea Sewa Priya Kee Preet Piyaree Mohan Ghar Aavho Karo Jodariya Mo Kao Taar Le Raama Taar Le Tere Kavan Kavan Gun Keh Keh Gawan Mera Baid Guru Govinda Saajanrraa Mera Saajanrraa

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