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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Depending on how sick the patient is, treatment will vary.

• If the patient is completely unconscious, all attempts will be made to save the person's life. A variety of invasive measures may need to be performed on the patient in order to closely monitor and evaluate the person.

• If the patient's condition is not grave, he or she will need a thorough investigation. Typically, the patient's clothes will be removed because leftover cyanide on clothing can continue to poison both the patient and those providing care.

• The patient may also have his or her stomach pumped if a recent ingestion of cyanide-containing substances is suspected. This is done by placing a tube down the mouth and into the stomach, followed by a thorough washing out of the stomach.

• A Cyanide Antidote Kit (CAK) or Hydroxocobalamin (Cyanokit) may be may be used if a strong suspicion for cyanide poisoning exists. Although not 100% successful, these antidotes can often prevent the cyanide from further poisoning the victim.

• If the person has carbon monoxide poisoning as well, hyperbaric oxygen therapy may be used if available. This requires placing the person in a special chamber that will give an extremely high amount of oxygen. Controversy still exists as to hyperbaric oxygen's definite role in the treatment of carbon monoxide poisoning.

• Usually the local poison control center or poison specialist (toxicologist) will be notified about the victim. Their assistance will help to determine the patient's care.

• If it is determined that the risk of actual cyanide ingestion is very low, the patient may be monitored for a few hours. If the patient appears well enough, he or she may be sent home with careful instructions to return immediately if any of the previous signs or symptoms develop.

• If a patient has had a significant cyanide exposure, has preexisting illnesses, or has an uncertain diagnosis and are too ill to go home, they will be admitted to the hospital for further treatment and observation.

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