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Nell GillettTreatment of Cyanide Poisoning

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Nell GillettTreatment of Cyanide Poisoning
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   ACMER –Cyanide Management in the Gold Industry –May 2009 Dr Nell Gillett –Medical Treatment1 Emergency Management:Emergency Management:   Treatment of Cyanide Treatment of Cyanide PoisoningPoisoning Wesfarmers CSBP KwinanaWesfarmers CSBP KwinanaDr Nell Gillett Dr Nell Gillett MBBS, GradDip (OHS), CIMEMBBS, GradDip (OHS), CIME Onsite Medical Officer Onsite Medical Officer  IntroductionIntroduction Cyanide is extremely toxic and Cyanide is extremely toxic and exposure may e aaexposure may e aaCyanide poisoning requires Cyanide poisoning requires immediate treatment,immediate treatment,Emergency diagnosis is difficult Emergency diagnosis is difficult     laboratory confirmation is delayed by laboratory confirmation is delayed by hours/dayshours/days   ACMER –Cyanide Management in the Gold Industry –May 2009 Dr Nell Gillett –Medical Treatment2 IntroductionIntroduction Lack of International consensus on “Best Lack of International consensus on “Best racce uenes or reamenracce uenes or reamenIs it cyanide poisoning?Is it cyanide poisoning?  May mimic other medical conditions which May mimic other medical conditions which require prompt medical attentionrequire prompt medical attention   Routes of absorptionRoutes of absorption InhalationInhalationIngestionIngestionThrough the eyes and skinThrough the eyes and skinDegree of symptoms depend on degree of Degree of symptoms depend on degree of exposureexposureSolid, liquid or gaseous phasesSolid, liquid or gaseous phases   ACMER –Cyanide Management in the Gold Industry –May 2009 Dr Nell Gillett –Medical Treatment3 Cyanide PoisoningCyanide Poisoning Cyanide causes cellular hypoxia by Cyanide causes cellular hypoxia by “inability of cells to use oxygen”“inability of cells to use oxygen”Impaired function of vital organ systemsImpaired function of vital organ systems  Nervous SystemNervous System  Cardiovascular Cardiovascular   RespiratoryRespiratory Lactic Acidosis (Metabolic)Lactic Acidosis (Metabolic)  Acute poisoning Acute poisoning Clinical effects determined byClinical effects determined by  Form of cyanide (gas produces the most rapid Form of cyanide (gas produces the most rapid onset of symptoms)onset of symptoms)  Mode of entry into bodyMode of entry into body  The doseThe dose RaidlactinieraidonsetofsmtomsRaidlactinieraidonsetofsmtoms    after exposureafter exposure   ACMER –Cyanide Management in the Gold Industry –May 2009 Dr Nell Gillett –Medical Treatment4 Signs of mild poisoningSigns of mild poisoning HeadacheHeadache Metallic tasteMetallic tasteDrowsinessDrowsinessDizziness Dizziness  Anxiety AnxietyIrritation of mucous membranesIrritation of mucous membranesShortness of breathShortness of breath Progression of poisoningProgression of poisoning Increasing shortness of breathIncreasing shortness of breathCyanosis Cyanosis Falling/ low blood pressure (hypotension)Falling/ low blood pressure (hypotension)Cardiac arrhythmiasCardiac arrhythmiasImpaired conscious stateImpaired conscious state
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