Advertisement

Cyanide Poisoning—“I’m Mr. Blue…”

  • Jessica A. EverettEmail author
  • Colin G. Kaide
  • Hannah Hays
Chapter

Abstract

Cyanide is a very old and revered toxin, deviously appearing in plants, seeds/pits, and in almost every household item made of plastic, polyurethane, or some such derivative. It works by blocking what is likely the most efficient energy-producing mechanism that nature has created, the production of ATP via oxidative phosphorylation. Toxicity includes collapse of all oxygen-dependent systems including, most importantly, the central nervous system (CNS) and the cardiovascular system. The treatment is supportive care while trying to remove the cyanide from the electron transport chain and reverse its devastating effects!

Keywords

Cyanide  House fire Hydroxocobalamin  Hyperlactatemia  Apricot pit  Anion-gap metabolic acidosis 

Notes

Disclosure Statement

  • Jessica A. Everett. Clarius. Not relevant to this publication

  • Colin Kaide. Callibra, Inc.-Discharge 123 medical software company. Medical Advisory Board Portola Pharmaceuticals. I have no relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product.

  • Hannah Hays No conflicts

References

  1. 1.
    Hamel J. A review of acute cyanide poisoning with a treatment update. Crit Care Nurse. 2011;31(1):72–81; quiz 2CrossRefGoogle Scholar
  2. 2.
    Holstege CP, Kirk MA. Cyanide and hydrogen sulfide. In: Weitz M, Naglieri C, editors. Goldfrank’s toxicologic emergencies. 10th ed: McGraw-Hill Education, Columbus, OH, USA; 2015.Google Scholar
  3. 3.
    Reade MC, Davies SR, Morley PT, Dennett J, Jacobs IC, Council AR. Review article: management of cyanide poisoning. Emerg Med Australas. 2012;24(3):225–38.CrossRefGoogle Scholar
  4. 4.
    McKenna ST, Hull TR. The fire toxicity of polyurethane foams. Fire Sci Rev. 2016;5(3):1.Google Scholar
  5. 5.
    Huzar TF, George T, Cross JM. Carbon monoxide and cyanide toxicity: etiology, pathophysiology and treatment in inhalation injury. Expert Rev Respir Med. 2013;7(2):159–70.CrossRefGoogle Scholar
  6. 6.
    Tshala-Katumbay DD, Ngombe NN, Okitundu D, David L, Westaway SK, Boivin MJ, et al. Cyanide and the human brain: perspectives from a model of food (cassava) poisoning. Ann N Y Acad Sci. 2016;1378(1):50–7.CrossRefGoogle Scholar
  7. 7.
    Hydrogen Cyanide - Emergency Department/Hospital Management. CHEMM. 14 January 2015.Google Scholar
  8. 8.
    Fortin JL, Desmettre T, Manzon C, Judic-Peureux V, Peugeot-Mortier C, Giocanti JP, et al. Cyanide poisoning and cardiac disorders: 161 cases. J Emerg Med. 2010;38(4):467–76.CrossRefGoogle Scholar
  9. 9.
    Hays H, McGrath J. Cyanide. In: Dr Carol Rivers’ preparing for the written board exam in emergency medicine, vol. 2. 8th ed. Ohio: ACEP; 2017. p. 579.Google Scholar
  10. 10.
    Lawson-Smith P, Jansen EC, Hyldegaard O. Cyanide intoxication as part of smoke inhalation—a review on diagnosis and treatment from the emergency perspective. Scand J Trauma Resusc Emerg Med. 2011;19:14.CrossRefGoogle Scholar
  11. 11.
    Bolarinwa IF, Orfila C, Morgan MR. “Amygdalin content of seeds, kernels and food products commercially-available in the UK” (PDF). Food Chem. 2014;152:133–9.CrossRefGoogle Scholar
  12. 12.
    Milazzo S, Horneber M. Laetrile treatment for cancer. Cochrane Database Syst Rev. 2015;4:CD005476.Google Scholar
  13. 13.
    Lerner IJ. Laetrile: a lesson in cancer quackery. CA Cancer J Clin. 1981;31(2):91–5.CrossRefGoogle Scholar
  14. 14.
    Hall AH, Dart R, Bogdan G. Sodium thiosulfate or hydroxocobalamin for the empiric treatment of cyanide poisoning? Ann Emerg Med. 2007;49(6):806–13.CrossRefGoogle Scholar
  15. 15.
    Anseeuw K, Delvau N, Burillo-Putze G, De Iaco F, Geldner G, Holmström P, et al. Cyanide poisoning by fire smoke inhalation: a European expert consensus. Eur J Emerg Med. 2013;20(1):2–9.CrossRefGoogle Scholar
  16. 16.
    MacLennan L, Moiemen N. Management of cyanide toxicity in patients with burns. Burns. 2015;41(1):18–24.CrossRefGoogle Scholar
  17. 17.
    Hall AH, Saiers J, Baud F. Which cyanide antidote? Crit Rev Toxicol. 2009;39(7):541–52.CrossRefGoogle Scholar
  18. 18.
    Thompson JP, Marrs TC. Hydroxocobalamin in cyanide poisoning. Clin Toxicol (Phila). 2012;50(10):875–85.CrossRefGoogle Scholar
  19. 19.
    Kirk MA, Gerace R, Kulig KW. Cyanide and methemoglobin kinetics in smoke inhalation victims treated with the cyanide antidote kit. Ann Emerg Med. 1993;22(9):1413–8.CrossRefGoogle Scholar
  20. 20.
    Kerns W 2nd, et al. Hydroxocobalamin versus thiosulfate for cyanide poisoning. Ann Emerg Med. 2008;51:338.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Jessica A. Everett
    • 1
    Email author
  • Colin G. Kaide
    • 1
  • Hannah Hays
    • 2
    • 3
    • 4
  1. 1.Department of Emergency MedicineWexner Medical Center at The Ohio State UniversityColumbusUSA
  2. 2.Department of Emergency Medicine, Wexner Medical Center at The Ohio State UniversityColumbusUSA
  3. 3.Central Ohio Poison CenterColumbusUSA
  4. 4.Nationwide Children’s HospitalColumbusUSA

Personalised recommendations