CME Information

Editorial Board

Lessons by Volume

Chemical Terrorism

By James A. Geiling, MD, FCCP

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**Table 2—**Cyanide*
Signs and Symptoms
Few; after exposure to high concentrations, seizures, respiratory and cardiac arrest
Detection
The M256A1 Detector kit detects hydrogen cyanide (AC) as vapor or gas in the air, and the M272 kit detects cyanide in water. The ICAD, M18A1, and M90 detectors also detect hydrogen cyanide. M8 and M9 paper do not detect cyanide.
Decontamination
Skin decontamination usually is not necessary because the agents evaporate rapidly. Wet, contaminated clothing should be removed and the underlying skin decontaminated with water or other standard decontaminants.
Management
Antidote: IV sodium nitrite and sodium thiosulfate Supportive: oxygen; correct acidosis
From the Medical Management of Chemical Casualties Handbook.*⁶

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