Cyanide poisoning is poisoning resulting from exposure to a number of cyanide forms. Early symptoms include headache, dizziness, rapid heartbeat, shortness of breath, and vomiting. This is then followed by seizures, slow heartbeat, low blood pressure, loss of consciousness, and heart attack. The onset of symptoms is usually within a few minutes. If a person survives, there may be long-term neurological problems.
Compounds containing toxic cyanides include hydrogen cyanide gas and a number of cyanide salts. Poisoning is relatively common after inhaling the smoke from house fire. Other potential exposure routes include workplaces involved in metal polishing, certain insecticides, nitroprussid drugs, and certain seeds such as apples and apricots. The liquid form of cyanide can be absorbed through the skin. Cyanide ions interfere with cellular respiration, so tissue can not use oxygen.
Diagnosis is often difficult. May be suspected of someone after a home fire that has a decreased level of consciousness, low blood pressure, or high blood lactate. Cyanide levels in the blood can be measured but it takes time. Levels of 0.5-1 mg/L light, 1-2 mg/L being, 2-3 mg/L weight, and greater than 3 mg/L generally result in death.
If exposure is suspected, the person should be excluded from the source of exposure and decontaminated. Treatment involves supportive care and giving the person 100% oxygen. Hydroxocobalamin (vitamin B12 a ) appears to be useful as an antidote and is generally first-line. Sodium thiosulfate may also be administered. Historically cyanide has been used for mass suicide and by the Nazis for genocide.
Video Cyanide poisoning
Signs and symptoms
Acute exposure
If cyanide is inhaled, it can cause coma with seizures, apnea, and cardiac arrest, with death after within seconds. At lower doses, loss of consciousness can be preceded by general weakness, dizziness, headache, vertigo, confusion, and perceived breathing difficulties. In the first stage of unconsciousness, breathing is often sufficient or even rapid, even though the person's condition develops into deep coma, sometimes accompanied by pulmonary edema, and finally a heart attack. The cherry red color of the cherry can be present as a result of increased venous hemoglobin oxygen saturation. Despite the same name, cyanide does not directly cause cyanosis. Doses that are fatal to humans can be as low as 1.5 mg/kg body weight.
Chronic exposure
Exposure to lower long-term cyanide levels (eg, after the incorrect use of untreated cassava roots as a major food source in tropical Africa) results in an increase in blood cyanide levels, which can cause weakness and various symptoms, including permanent paralysis. , nerve lesions, hypothyroidism, and miscarriage. Other effects include mild liver and kidney damage.
Maps Cyanide poisoning
Cause
Acute hydrogen cyanide poisoning may result from inhaling smoke from the burning of polymer products using nitrile in its production, such as polyurethane, or vinyl. This can also be caused by damage of nitroprusside to nitric oxide and cyanide. Nitroprusside can be used during the treatment of hypertensive crisis.
In addition to its use as a pesticide and insecticide, cyanide is contained in tobacco smoke and smoke from building fires, and is present in many seeds or seeds such as almonds, apricots, apples, oranges, and foods including cassava (also known as yuca or manioc), and bamboo shoots. Vitamin B12, in the form of hydroxocobalamin (also spelled hydroxycobalamin), can reduce the negative effects of chronic exposure, and deficiency can cause negative health effects after exposure.
Mechanism
Cyanide poisoning is a form of histotoxic hypoxia because organism cells can not create ATP, especially through inhibition of the mitochondrial enzyme cytochrome c oxidase. Cyanide is rapidly metabolized to 2-amino-2-thiazoline-4-carboxylic acid and thiocyanate with a half-life of 10-30 minutes as a detoxification mechanism. Within hours of a single consumption, no cyanide can be detected, because it is metabolized unless death occurs first. (Cyanide detection long after consumption is considered a false positive indication in diagnostics.) Thiocyanate has a long half-life & gt; 24 hours, and is usually removed through the kidneys. The Tiocyanate has ~ 1/100th toxicity of the cyanide parent molecule.
Diagnosis
Long detection methods involve colorimetric tests such as Prussian Blue test, pyridine-barbiturate test, also known as "Conway diffusion method" and taurine fluorescence-HPLC but like all colorimetric tests, this can be prone to positive errors. Lipid peroxidation, cardiac arrest artifacts produce cross-reacted dialdehyde with a pyridine-barbiturate test. Meanwhile, HPLC-taurine-fluorescence test used for cyanide detection is identical to the test used to detect glutathione in spinal fluid. Recently, cyanide and thiocyanate tests have been carried out with mass spectrometry (LC/MS/MS), which are considered special tests. Since cyanide has a short half-life, the primary metabolite, thiocyanate is usually measured to determine exposure.
Treatment
Decontamination
Decontamination of people exposed to hydrogen cyanide gas requires only the release of the outer garments and washing their hair. Those exposed to liquids or powders generally require full decontamination.
Antidote
The first US standard cyanide antidote kit uses a small inhaled dose of amyl nitrite, followed by intravenous sodium nitrite, followed by intravenous sodium thiosulfate. Hydroxocobalamin has just been approved in the US and is available in the Cyanokit toxic antidote. Sulfanegen TEA, which can be delivered to the body via intra-muscular injection (IM), detoxifies cyanide and converts cyanide to thiocyanate, a substance that is less toxic. Alternative methods for treating cyanide poisoning are used in other countries.
History
Burning
- On December 5, 2009, a fire at Lame Horse nightclub (Khromaya Loshad) in the Russian city of Perm took the lives of 156 people. 111 people died on the spot and 45 later in the hospital. One of the main causes of death is poisoning from cyanide and other toxic gases released by the burning of plastic foams and polystyrene used in the construction of the club's interior. Considering the number of deaths, this is the biggest fire in post-Soviet Russia.
- On January 27, 2013, a fire at a Kiss nightclub in the town of Santa Maria, in southern Brazil, caused the poisoning of hundreds of young people by cyanide released by the burning of a polyurethane soundproof foam. As of March 2013, 241 fatalities were confirmed.
Chamber chamber
- Hydrogen cyanide in the form of Zyklon B was used in German extermination camps during World War II, and especially from March 1942 onwards, when it was first used experimentally to kill Russian prisoners of war in Auschwitz. The toxic use was rapidly upgraded until a specially built gas chamber (accommodating up to 2,000 victims) was built as part of the new crematorium complex at Auschwitz-Birkenau. There was also a large dressing room next to the gas chamber, and the victims were told to undress and leave their clothes in the numbered pegs for later collections. They were told that they would receive a hot shower, and a fake shower head mounted on the ceiling of the gas chamber, so as to keep the scam. The gas chambers are sealed tightly to prevent gas leakage. The Zyklon B pellet then falls into the room through a small hole in the roof. When pellets are exposed to humidity and human heat (as in enclosed spaces), they emit HCN gas, which then kills the victim. Workers in Sonderkommando were hired to remove the bodies from the gas chamber and peel away all valuables, such as gold teeth, before the corpses were cremated. Gas is used mainly in Auschwitz, Majdanek and Mauthausen-Gusen concentration camps.
- Hydrogen cyanide gas has also been used for judicial execution in some states of the United States, where cyanide is produced by a reaction between potassium cyanide (or sodium cyanide) falling into a compartment containing sulfuric acid, just beneath the seat in a cubic gas.
War
Cyanide was stockpiled in chemical weaponry both in the Soviet Union and the United States in the 1950s and 1960s. However, as a military agent, hydrogen cyanide is not considered very effective, because it is lighter than air and requires significant doses to immobilize or kill.
Suicide
Source of the article : Wikipedia
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