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Antidote kits available for cyanide poisoning in the U.S. contain three medications that must be administered in a specific order. First, amyl nitrite is given through inhalation. If oxygen and amyl nitrate is not successful in treating the victim, then sodium nitrite is infused intravenously. This is followed by the infusion of intravenous sodium thiosulfate. Other antidotes that can be administered in the field have been used in other countries, but are not available in the U.S. These include hydroxocobalamin, a precursor of vitamin B12 that has been used safely and effectively in France under the trade name Cyanokit. Dicobalt ededate is used in the United Kingdom to treat cyanide poisoning and 4-dimethylaminophenol (DMAP) is used in Germany as an antidote for severe cyanide poisoning in patients who are in a deep coma and who have dilated non-reactive pupils and deteriorating cardiorespiratory function.
A new type of personal detection device called the Chameleon uses chemical reactive tabs in a wristband holder to determine when dangerous levels of gases are present in a given atmosphere. The interchangeable tabs undergo a color change indicating the presence of a suspected type of gas. Each wristband has the capability of detecting eight gases simultaneously. The person wearing the wristband just needs to watch for the color changes. Cyanide is one of the gases that the Chameleon can detect. This device could be helpful during overhaul when invisible toxic gases such as hydrogen cyanide may be present.
The National Association of EMS Educators (NAEMSE) provides one-day seminars titled "Cyanide Detection and Treatment." Information can be obtained at www.naemse.org.
ROBERT BURKE, a Firehouse contributing editor, is the fire marshal for the University of Maryland-Baltimore. He is a Certified Fire Protection Specialist (CFSP), Fire Inspector II, Fire Inspector III, Fire Investigator and Hazardous Materials Specialist, and has served on state and county hazardous materials response teams. Burke is an adjunct instructor at the National Fire Academy and the Community College of Baltimore, Catonsville Campus, and the author of the textbooks Hazardous Materials Chemistry for Emergency Responders and Counter-Terrorism for Emergency Responders. He can be contacted at firstname.lastname@example.org.