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Cyanide Poisoning (cont.)

What are common sources and causes of cyanide poisoning?

Common sources of cyanide poisoning include:

  • Fires: Smoke inhalation during the burning of common substances such as rubber, plastic, and silk can create cyanide fumes and cause cyanide poisoning.
  • Photography, chemical research, synthetic plastics and fibers, metal processing, fumigation and pesticides, mining, and electroplating industries use hydrogen cyanide. Potassium cyanide is used in gold and silver extraction, chemical analysis, to make other chemicals, and as an insecticide.
  • Plants: Mostly from the family Rosaceae, seeds and pits from plants such as apricot, bitter almond, cherry laurel, plum, peach, pear, and apple contain cyanogenic glycosides. A type of potato called cassava can also cause cyanide poisoning. Fortunately, only chronic or massive ingestion of any of these plants or pits can cause serious cyanide poisoning.
  • Laetrile, a compound that contains amygdalin (a chemical found in the pits of raw fruits, nuts, and plants) has been purported as a cancer treatment worldwide. One of the side effects of laetrile is cyanide poisoning. The Food and Drug Administration (FDA) has not approved laetrile as a cancer treatment in the United States. The drug is also made and used as a cancer treatment in Mexico under the name "laetrile/amygdalin."
  • Certain chemicals, after ingestion, can be converted by the body into cyanide and cause cyanide poisoning. Most of these chemicals have been removed from the market, but some old artificial nail polish removers, solvents, and plastics manufacturing solutions can contain these substances.
  • Cigarette smoke is the most common source of cyanide exposure for most people. Cyanide is naturally found in tobacco, and smokers can have more than 2.5 times the mean whole blood cyanide level of nonsmokers, though this is generally not enough to cause poisoning.

Those most at risk of cyanide poisoning are those who work in industries that use this chemical and people who intentionally try to kill themselves. Those who attempt suicide by using cyanide pills or capsules may believe it is a quick and painless death, however, cyanide burns the stomach and prevents the body from using oxygen, causing a painful death.

For most people, cyanide only causes poisoning if a fire occurs or if some of the compounds mentioned above are accidentally ingested.

When to seek medical care for cyanide poisoning

If you or someone you know has ingested, inhaled or been exposed to cyanide, and you or they have signs or symptoms, such as weakness, dizziness, trouble breathing, confusion, or seizure, you must immediately call an ambulance, the emergency response system in your area, or a poison control center. In the United States, the National Poison Control Center contact number is 1-800-222-1222.

It can be very difficult to determine if someone has been exposed to cyanide. If you are in doubt, it is always best to contact a health care professional. If the victim is not in danger, contact your local poison center for instructions.

  • In the United States, you can find your local poison center at the American Association of Poison Control Centers. The U.S. National Poison Control Center phone number is 1-800-222-1222. This number is routed to the poison control center that serves your area. Place the telephone number (along with police, fire, and 911 or equivalent) near your home phones.
  • Calling the National Poison Control Center, or the poison control center in your area would be appropriate for example, if the potential victim accidentally swallowed a few apricot pits or breathed in a little too much smoke during a bonfire.
  • If the victim is unconscious, collapses, has a seizure, is acting confused, or feels short of breath this is a medical emergency, and your local emergency response system, 911, or an ambulance should be contacted immediately.
  • In most cases, calling 911 and waiting for the ambulance to arrive is the best thing to do.
  • Do not induce vomiting or give syrup of Ipecac.
    • Ipecac was formerly used to induce vomiting in poisoned patients where there was a chance to get the toxin out of the body. Several advisory bodies such as the American Association of Poison Control Centers and the American Academy of Pediatrics have recommended that Ipecac NOT be used and that it should not even be kept in the household. For more information on this subject go to: http://www.poison.org/prepared/ipecac.asp
  • Do not give activated charcoal at home. Allow medical personnel to decide if this treatment is appropriate.
  • The poison control center will provide instructions in regard to what action to take.

How is cyanide poisoning diagnosed?

Treatment in a hospital's emergency department will depend on the victim's level of illness.

  • Cyanide poisoning is a treatable condition, and it can be cured if detected quickly and treatment is started immediately. Most people die because the diagnosis is not made quickly enough, or it is not considered from the start. Cyanide poisoning is rare, so the treating physician should be alerted of the possibility. This may be one of the most important things you can do to help the victim.
  • If you are the rescuer, you will be asked questions about what happened to the victim. You will be asked if there were any bottles lying around, if the victim had any medical or psychiatric problems, and other details. Stay calm and answer the questions, because this is vital information necessary to care for the injured person.
  • Blood tests, X-rays, and other procedures will be necessary to try to determine if cyanide poisoning has occurred, how bad the poisoning is, or if some other type of poisoning has occurred.
  • The diagnostic test to detect cyanide takes hours to days to perform. Thus, the doctors will rely on a combination of what you tell them, what the victim looks like, and supporting laboratory data to decide the likelihood of actual cyanide exposure.
  • A prototype diagnostic test for the detection if cyanide has been developed at South Dakota State University that can detect it within 70 seconds. More study is needed to determine accuracy and to develop a smaller device with replaceable cartridges.
Medically Reviewed by a Doctor on 9/23/2016

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Read What Your Physician is Reading on Medscape

Toxicity, Cyanide »

Cyanide, one of the most rapidly acting lethal poisons known to humankind, was a main constituent of Earth's primordial atmosphere and probably played an important role in the development of life on Earth.

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