Potassium Cyanide Poisoning

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Potassium cyanide is a potassium salt of hydrocyanic acid. Outwardly, this chemical compound is similar to granulated sugar crystals. During the hydrolysis of potassium cyanide, hydrogen cyanide is released - a gas with a characteristic smell of bitter almonds, which, however, can be felt by no more than 50% of people, which is associated with genetic factors.

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Potassium cyanide is used in the extraction of silver and gold ores using the cyanidation method. Also, this substance is used in electroplating methods for obtaining copper, cadmium, zinc, gold and silver.

Failure to work with potassium cyanide in a workplace or laboratory can lead to poisoning.

How does potassium cyanide poisoning occur?

Potassium cyanide poisoning most often occurs as a result of inhalation of its aerosol (air suspension), but it can also be the result of its penetration into the body through the gastrointestinal tract or due to absorption through the skin or mucous membranes.

Once in the body, potassium cyanide almost instantly blocks cytochrome oxidase, as a result, the process of cellular respiration stops: despite the fact that oxygen continues to flow with the blood stream, the tissues can no longer assimilate it. Hypoxia develops and increases rapidly. Since oxygen is not absorbed by cells, its content in venous blood increases sharply and becomes the same as in arterial blood - outwardly, this is manifested by the bright scarlet color of the mucous membranes.

For an adult, the lethal dose of potassium cyanide is 1.7 mg / kg body weight.

Poisoning symptoms

The clinical picture of potassium cyanide poisoning has several stages.

Prodromal stage

This stage is characterized by:

rapid breathing;
dizziness;
a feeling of compression in the chest;
nausea and vomiting;
hypersalivation;
metal taste in the mouth;
perspiration and / or numbness in the oropharynx.

Dyspnoetic stage

Its development is associated with a further increase in tissue hypoxia:

increasing bradycardia;
feeling of anxiety and fear of death;
dilated pupils;
bulging of the eyeballs;
severe shortness of breath.

Convulsive stage

Increasing hypoxia leads to significant damage to the cerebral cortex, which has the following symptoms:

loss of consciousness;
convulsions;
involuntary urination and defecation;
biting the tongue.

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Paralytic stage

This is the terminal stage of potassium cyanide poisoning. It is characterized by:

cessation of seizures;
the disappearance of reflexes;
loss of pain sensitivity.

Breathing becomes shallow and arrhythmic, the frequency of respiratory movements decreases and soon they completely stop, the heart stops.

Throughout all the stages of potassium cyanide poisoning, the victims have a bright scarlet color of the mucous membranes, and sometimes the skin, which persists even after the onset of a lethal outcome.

First aid for poisoning with potassium cyanide

In case of poisoning with potassium cyanide, the victim should be evacuated from the contaminated room to fresh air as soon as possible. It is necessary to take off his clothes, which could get poison. Clothes should not be taken off over the head, as this will lead to additional penetration of poison into the respiratory tract; it is most rational in such a situation to cut it.

The skin and mucous membranes should be washed with 2% sodium bicarbonate solution (1 teaspoon of baking soda per 200 ml of water), then with clean water.

If the poison has entered through the gastrointestinal tract, provided that the victim is conscious, they begin to wash the stomach (give a few glasses of warm salted water to drink and induce vomiting by pressing on the root of the tongue).

Sugar or sugar syrup can be used as an antidote at the prehospital stage.

If a state of clinical death occurs, the victim is given an indirect heart massage. Artificial ventilation by mouth-to-mouth method is contraindicated, as it can cause poisoning in the person providing first aid.

When is medical attention needed?

In case of poisoning with potassium cyanide, it is important to call an ambulance to the victim as soon as possible, since without specialized therapy the chances of survival are extremely small.

There are several antidotes to potassium cyanide, which are used all at once, since each of them affects various links in the pathological mechanism of intoxication:

methemoglobin formers (methylene blue, sodium nitrite, amylnitrite, nitroglycerin) - they split oxygen from the hemoglobin molecule, which allows cyanide to be removed from cells;
sulfur-containing agents (sodium thiosulfate) - give off a sulfur ion, due to which the neutralization of potassium cyanide occurs;
sugars (hypertonic glucose solution) - combine with molecules of potassium cyanide, converting them into a non-toxic form.

Oxygen and symptomatic therapy is carried out. Respiratory analeptics (Bemegrid, Tsititon, Karbolen) are used to stimulate the respiratory center.

Possible complications

Potassium cyanide poisoning is fatal in most cases. If the victim survives, in the future there is a high risk of developing persistent disorders of neurological functions, mental disorders, lability of blood pressure and pulse.

Prevention

Potassium cyanide poisoning is usually observed in factories and laboratories, so it is important to carefully follow safety precautions to prevent them. All devices that use poison must be carefully sealed. When working with potassium cyanide, employees must use personal protective equipment (gas mask, rubber gloves, chemical protection suit).

All rooms in which a leak of potassium cyanide can occur must be provided with a special alarm that is triggered when the content in the air exceeds the maximum permissible concentration of poison.

Employees of the enterprise should be regularly trained to teach them how to provide first aid in case of poisoning with cyanide potassium.

Elena Minkina Doctor anesthesiologist-resuscitator About the author

Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.

Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.

The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!