Cyanide Poisoning
Introduction
Introduction to cyanide poisoning Cyanide is a highly toxic substance, including hydrogen cyanide, sodium cyanide, potassium cyanide, ammonium cyanide and acrylonitrile. Hydrogen cyanide and acrylonitrile fumes can be quickly absorbed through the skin and respiratory tract. Cyanide poisoning is caused by cyanide entering the body through the skin, respiratory tract or digestive tract. The initial poisoning symptoms of cyanide poisoning are dizziness, headache, accelerated breathing rate, late cyanosis (dark purple due to lack of oxygen) and coma; some people with poisoned breathing can smell the unique almond flavor of cyanide. Exposure to high doses can damage the brain and heart in a short period of time, causing coma and death; long-term exposure at low doses may cause difficulty breathing, heartache, vomiting, blood changes (increased hemoglobin, increased number of lymphocytes) , headache and thyroid enlargement. If high levels of cyanide are ingested, there may be breathlessness, shortness of breath, fainting, loss of consciousness or death. There will be ulceration, skin irritation and erythema after skin contact; there will be irritation, burns, blurred vision after eye contact, and excessive or delayed contact will cause permanent damage to the eyes. basic knowledge Sickness ratio: 0.0001%-0.0005% Susceptible people: no specific population Mode of infection: non-infectious Complications: cerebral edema, respiratory failure, headache
Cause
Causes of cyanide poisoning
Contact with toxic materials (30%):
There are many types of cyanide, and hydrogen cyanide gas can be released during the chemical reaction process, especially when high temperature and acidic substances act. Common operations include electroplating, metal surface carburization and photographers, precious metals extracted from ore, chemical industry manufacturers, resins and other raw materials.
Ingestion of poisoned food (30%):
The state of application is gaseous and vaporous, mainly caused by respiratory inhalation, poisoning, and poisoning caused by eating food and water. In addition, skin contact can also be poisoned.
Other factors (10%):
Inhalation, misuse of cyanide or swallowing excessive amounts of cyanide-containing nuts, and suicide or poisoning are also the cause of cyanide poisoning.
Prevention
Cyanide poisoning prevention
1. Nuts containing cyanide, such as peach, apricot, wholesale, plum, bayberry, cherry, etc., do not overdose.
2. Strengthen personal protection, wear accidental masks and enter the scene to rescue, should wear gas masks.
3. Strictly follow the operating procedures and popularize anti-virus and first-aid knowledge.
4. Chemical industry manufacturers should strictly abide by the operating procedures when working.
5. Popularize anti-virus and first-aid knowledge and raise public awareness of anti-drugs.
Complication
Cyanide poisoning complications Complications brain edema respiratory failure headache
Severe poisoning manifests as loss of consciousness, tonicity and paroxysmal convulsions, until angulation, blood pressure drops, urine, incontinence, often accompanied by cerebral edema and respiratory failure, the chronic effects of hydrocyanic acid on the human body are expressed as nerves Debilitating syndrome, such as dizziness, headache, fatigue, chest pressure, muscle pain, abdominal pain, etc., and may have eye and upper respiratory tract irritation, after long-term skin contact, can cause rash, manifested as macules, papules, extremely itchy.
Symptom
Symptoms of cyanide poisoning Common symptoms Coma, nausea, reflexes, irritability, restlessness, dizziness, blood pressure, light, reflection, disappearance, convulsions, difficulty in breathing, limb weakness
1. Inhalation of high concentrations of hydrogen cyanide or oral administration of large doses of sodium cyanide or potassium cyanide may result in a "lightning" sudden death, which may cause respiratory arrest and death in 2-3 minutes.
2. General acute poisoning prodromal period: eye, pharynx and upper respiratory tract irritation or oral numbness, burning sensation, runny nose, nausea, vomiting, etc., accompanied by dizziness, headache, fatigue, chest tightness, tinnitus, urgency of stool.
3. General acute poisoning dyspnea period: chest pressure oppression, dyspnea, exhaled breath with almond flavor, elevated blood pressure, arrhythmia, disturbance of consciousness, skin and mucous membrane is bright red.
4. General acute poisoning flood season: convulsions, incontinence, superficial breathing, loss of consciousness. 5. General acute poisoning paralysis period: the whole body muscles are slack, the feeling and reflex disappear, and finally the breath and heartbeat stop.
Examine
Cyanide poisoning check
1. Laboratory examination: The poison can be analyzed on the air and articles in the poisoned environment. The cyano group can be detected in the blood of the poisoned patient, and the concentration of thiocyanate in the urine increases.
2. Blood oxygen partial pressure: The difference of arteriovenous oxygen partial pressure difference can be used as one of the diagnostic clues of cyanide poisoning.
3. Imaging examination: Early chest X-ray examination is generally normal.
Diagnosis
Diagnosis and identification of cyanide poisoning
diagnosis
Mainly relying on medical history and spit to find poison residue, the patient may sometimes have almond flavor in the breath, which can help diagnosis. When suspected cyanide poisoning, special antidote can be used for diagnostic treatment. As for the cyanide analysis The method is complicated and can be implemented by non-general hospitals. The immediate diagnosis of cyanide poisoning is difficult. It must be considered according to the history of exposure, high AG acid and refractory hypoxemia.
Differential diagnosis
Acute cyanide poisoning poisoning should be differentiated from neurotoxic agents and carbon monoxide poisoning. Neurotoxic agent poisoning is often muscarinic, nicotinic and central nervous symptoms; skin mucosa purpura, blood AchE activity is decreased, carbon monoxide poisoning is mostly coma Innocent or accompanied by mental symptoms, skin and mucous membrane cherry red, and other suffocating poisons such as nitrogen, hydrogen sulfide and other acute poisoning, in addition, should also be differentiated from diabetic coma, encephalitis and epilepsy.
