Cyanide Poisoning

Etiology

  • Cyanide inhibits oxidative phosphorylation, ATP production, and intracellular O2 use - all resulting in tissue level hypoxemia and acidosis

Risk Factors

  • Inhalation in smoke during industrial or house fires
  • Industrial exposures (ie accidents at work)
  • Purposefully overdose (suicide attempt)
  • Intent to harm (poisoning, mass exposure via terrorist activities)

Symptoms

  • Vary with severity and time from exposure
  • Early/mild: fatigue, malaise, headache, dizziness, nausea, confusion, vomiting
  • Later/more severe: dyspnea, more confusion, coma, syncope, seizures, death

Physical Exam Findings

  • Tachycardia, tachypnea, confusion
  • Cyanosis, bradycardia, hypotension, cardiovascular collapse, dilated pupils, non-responsiveness
  • Cherry red skin and bitter almond smell relatively uncommon

Tests

Links