First aid for cyanide poisoning

August 2012

Cyanide poisoning

Cyanide compounds are very toxic to humans, and inhalation exposure can be rapidly fatal. Cyanide compounds prevent the transfer of oxygen from the blood to body tissues as a result of selective inhibition of respiratory enzymes. The heart and central nervous system are particularly prone to rapid damage. Cyanides can enter the body by inhalation, by contact with the skin or eyes and if swallowed.

Although cyanide poisoning is uncommon, all staff and students working with or studying in areas using or storing cyanide must be familiar with the first aid required for cyanide poisoning. The most likely injury is to the person using the material but production of hydrogen cyanide gas in an open laboratory could have serious consequences for all occupants. The critical factor is the speed with which the first aid can be started after exposure.

Symptoms of cyanide poisoning

Mild or early cyanide poisoning
Severe cyanide poisoning

Irritation of nose, mouth and throat

Gasping for breath

Headache, giddiness, nausea

Lapsing consciousness

Difficulty breathing, sense of suffocation

Convulsions

General weakness, heaviness of limbs

Death

First Aid provisions when using Cyanide

Where cyanide is used at Monash University, Medical oxygen must be available and first aiders must have completed oxygen therapy training. All oxygen cylinders must be maintained according to Procedures for First Aid, section 13.2.

First aid for cyanide poisoning

Speed is essential - treatment must be prompt to be effective

First aid assistance should only be rendered if there is no suspected cyanide gas/dust in the immediate environment

If cyanide gas/dust is suspected;

  • Do not enter the area
  • Contact Emergency services on (0) 000 from a Monash phone or 112 from a mobile
  • Call security on 333
  • Double glove to avoid contamination from patient's skin/clothes

If patient is conscious;

  • Administer medical oxygen at maximum rate
  • Remove contaminated clothing and place in biohazard bag labeled "Contaminated with Cyanide" until it can be decontaminated
  • Wash all contaminated skin with copious amounts of water for at least 20 minutes
  • Continue treatment until medical assistance arrives

If patient is not conscious

Check airway and clear if necessary (use Nitrile gloves as above)

If breathing:

  • Place on side
  • Administer medical oxygen at maximum rate.
  • Remove contaminated clothing and place in a biohazard bag labeled "Contaminated with Cyanide" until it can be decontaminated
  • Wash all contaminated skin with copious amounts of water for at least 20 minutes
  • Continue treatment until medical assistance arrives

If not breathing:

Check airway and clear if necessary (use Nitrile gloves as above)

Do not use mouth to mouth or mouth to nose resuscitation, due to risk of contamination.

  • Administermedical oxygen at maximum rate via resuscitation mask
  • RRemove contaminated clothing and  place  in  a biohazard bag labeled contaminated with Cyanide until they it  be decontaminated
  • Begin external cardiac compression
  • Wash all contaminated skin with copious amounts of water for at least 20 minutes
  • Continue treatment until medical assistance arrives

In all cases a copy of the Material Safety Data Sheet (MSDS) should accompany the patient to hospital.

The affected person's supervisor should be notified immediately.

A first aid injury report and hazard & incident report should be completed and sent to Occupational Health and Safety as soon as possible.

For disposal of contaminated clothing, refer to Using Chemicals at Monash University

First Aid Module for Cyanide Poisoning (see 12.3 in the Procedures for First Aid)

This module should be clearly marked in a separate container and be readily accessible to the area where cyanide is used. It should be located adjacent to the first aid kit and medical oxygen.

Contents of module:

  • Copy of appropriate MSDS
  • Nitrile Gloves (8 pairs)
  • Biohazard bags  labelled with "Contaminated with Cyanide"
  • First aid injury report
  • Hazard & incident report
  • Trauma shears (to assist with removal of clothes)

Further information and advice contact:

Occupational Health & Safety:

Poisons Information Centre Victoria:

  • Telephone: 131126 (24 hours)