A new Technical Report has been published by the European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) that reviews the efficacy, efficiency, safety and practicality of the various antidote regimes used under different cyanide poisoning circumstances.
The comprehensive review is based on a literature survey and the analysis and statistical evaluation of more than 400 cases of poisoning by cyanides.
Cyanide poisoning, which can have very serious neurological consequences that may result in severe disability and death, may occur after ingestion, inhalation, or dermal contact with hydrocyanic acid, cyanide salts or cyanide-forming compounds. And while antidotes for cases of poisoning exist, there is no recognised consensus on when to apply the various antidotes being used around the world.
The report concludes that certain antidotes, namely sodium thiosulfate, amyl nitrite and hydoxocobalamin, when administered alone, counteract moderate to severe poisoning. The combination of sodium nitrite and sodium thiosulfite, with or without amyl nitrite, was also effective in severe poisonings. Other antidotes were found not to be as effective, or are not recommended.
Recommendations are also given for use by first aiders in industry.