Identifying Cyanide Poisoning in Victims

Unfortunately, there is no widely available rapid-acting blood test to confirm cyanide poisoning in a patient on the scene of an accident or structure fire, the most common route of cyanide poisoning. Therefore, cyanide poisoning must be identified presumptively in order to initiate life-saving interventions in a timely manner.

At the scene of a fire, cyanide poisoning should be suspected in any person exposed to smoke in a closed-space regardless of whether burns have been sustained. Soot in the mouth and around the nose, combined with an altered level of consciousness, also suggests a high probability of cyanide toxicity. Scientific study has helped identify a "Cyanide Toxidrome" which includes altered mental status with mydriasis, low respiratory rate, low systolic blood pressure with increased heart rate and metabolic acidosis with a large increase in plasma lactate.

Signs and symptoms of cyanide poisoning may vary depending on the source and route of exposure as well as the amount of cyanide within the exposure:

Certain laboratory tests, which can be performed at a hospital, can also help identify the presence of cyanide in the body. These include:

• Elevated venous blood oxygen concentration
• Elevated plasma lactate concentrations
• Metabolic acidosis