Letter 32064

Cyanide Poisoning Antidote  

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I recently read an article in one of the current issues of the AESF magazine about cyanide poisoning in a plating shop in Indiana. I was always under the assumption that the antidote for cyanide poisoning was Amil Nitrate and according to this article it said Sodium Thiosulfate they had used for the antidote. I know in our plating we still use a lot of cyanide our plating baths and I know the antidote shot we have is Amil Nitrate that is what was recommended to us from our company's doctor. Maybe somebody could shed some light on this for me and point me in the right direction?

Brian Gaylets
McKinney Products - Scranton, Pennsylvania, U.S.A.

The amyl nitrite (street name 'popper's) is an inhalation therapy. It's the first step in a protocol in which, as I recall, injection of another chemical is a second step. The full details are in The Canning Handbook.

As for the amyl nitrite, I don't think it is considered an appropriate treatment by the medical community anymore; I believe they currently feel that administration of oxygen is safer and better. But you need to acquire it anyway because OSHA fines people for not having it. Whether you should or shouldn't administer it is something I won't hazard a guess about, but perhaps your company doctor will advise.

The second step, injection, is something that only qualified medical personnel can do! Readers shouldn't even think about it if you are not. The reason to have it on hand is for the EMTs and the emergency room doctors.

That was a scary story in P&SF if it is an accurate transcription of events. The patient did not get any treatment from the rescue squad, he was just allowed to die. And his death may well have been from a heart attack, and have had nothing to do with cyanide poisoning. And we'll never know because the coroner refused to perform an autopsy because of his perception of great danger in doing so.

Ted Mooney, P.E.  finishing.com Brick, New Jersey

The agreed correct procedure in the UK is to administer oxygen and get immediate medical help. Under no circumstances should anyone start injecting potential patients with anything unless they are medically qualified. It is easy to inject an air bubble into the blood system and that will definitely kill the patient. Furthermore, if someone does give an injection, the patient or their next of kin could successfully sue for assault. The cyanide antidote kit is there ONLY for the use of qualified medical personnel. I know it sounds hard, especially if your work mate has possibly been exposed to cyanide, but, regrettably, it is a fact of life - the only thing you can do is try to sustain life with oxygen so the experts can do their job. By the way DO NOT give mouth-to-mouth resucitation; if you have a ventilating mask with a non-return valve in it, use that. As long as the patient is conscious, keep them calm; if they stop breathing and lose their heartbeat, then start CPR, but NOT m-t-m.

Trevor Crichton R&D practical scientist - UK

Please see a very detailed reply, posted today, on letter 12574.

Ted Mooney
finishing.com - Brick, NJ

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