Hydrogen cyanide

CAS RN: 74-90-8

Agent Specific

Triage

Cyanide Agent Specific Triage

High concentrations of cyanide gas can cause death in minutes; however, low concentrations may produce symptoms gradually, causing challenges for the triage officer. Generally, a person exposed to a lethal amount of cyanide will die within 5 to 10 minutes of exposure.

Immediate - Unconscious/seizures, apnea, severe airway, GI, or skeletal muscle involvement.

If circulation is still intact, antidotes will restore the patient to a reasonably functional status in a short period of time.

Delayed - Significant but not life threatening respiratory involvement/systemic effects, changed mental status.

Minimal - Walking and talking patients.

Casualties exposed to cyanide vapor who have survived for 15 minutes can be categorized as minimal or delayed.

Contamination of conventional injuries with cyanide can result in respiratory depression and reduction of the oxygen carrying capacity of the blood. Urgent use of cyanide poisoning antidote is required. Oxygen therapy combined with positive pressure resuscitation may be required sooner in the presence of marked hemorrhage from the conventional injury. Opiates and other drugs that reduce respiratory drive must be used with extreme caution.

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