CPTC Supports the Homeland Security Presidential Directive

Falls Church, VA February 12, 2007 - On February 7, 2007, the White House released a Homeland Security Presidential Directive/HSPD-18 on the medical countermeasures against Weapons of Mass Destruction. Addressed was the nation's strategy to combat WMD, the feasibility to develop and stockpile medical countermeasures against every possible threat, the challenges presented by the diverse chemical, biological, radiological and nuclear agents (CBRN) and mitigating illness and preventing death.

The Cyanide Poisoning Treatment Coalition (CPTC), a national non-profit organization seeking to foster a rational approach to the diagnosis and treatment of cyanide poisoning through increased research, advocacy and education, supports the policies and actions of the Presidential Directive on many levels:

Focused development of agent-specific medical countermeasures;
Development of a flexible capability for new medical countermeasures;
Employ an integrated approach to WMD medical countermeasures development;
Establishment of an interagency committee to provide advise in setting medical countermeasures requirements and coordinate research, development and procurement activities;
Engaging the private sector and nongovernmental entities; and
Development of a strategic, integrated all-CBRN risk assessment that integrates the findings the intelligence and law enforcement communities with input from the scientific, medical, and public health communities.

CPTC President Dr. Donald W. Walsh, a 30-year Fire and EMS Service member, emphasized the importance of HSPD-18. "Cyanide is so easy to obtain here in the United States. Cyanide is used in many industrial applications, and with so much availability of the chemical, we need to be prepared and develop appropriate countermeasures, including antidotes and chemical treatment stockpiles," Walsh said.

Because cyanide possesses many of the characteristics of an "ideal" terrorist weapon, the U.S. Center for Disease Control and Prevention (CDC) and the Department of Homeland Security consider it to be among the most likely agents of chemical terrorism. CPTC recognizes and addresses the limited awareness of sources of cyanide poisoning posing a risk to the health and safety of communities across the country, and leading fire, medical and industry organizations.

"The general lack of knowledge about cyanide poisoning and insufficient antidote stocking levels are alarming and are two essential areas in which the CPTC focuses its educational efforts," said Dr. Walsh. "The CPTC provides and continues to develop and implement a variety of educational programs and tools to assist fire service and emergency response managers and emergency medical providers, including doctors, nurses and first responders, to help improve emergency preparedness, early recognition and response to incidents of cyanide poisoning."

Background

Previous studies have gauged the awareness of cyanide via exposure risk and treatment preparedness:

RTI National Survey on Cyanide Risk and Preparedness

Conducted by RTI (Research Triangle Institute) International, this survey polled Advanced Life Support (ALS) emergency medical service (EMS) providers from 832 fire departments and 507 ALS providers around the country. Findings included:

Only 35 percent polled believed they were likely or very likely to be exposed to cyanide as a result of a fire in their service area in spite of information from the Agency for Toxic Substances and Disease Registry (ATSDR) of the U.S. Department of Health and Human Services, indicating that a majority of the estimated 1.838 billion pounds of cyanide produced in the U.S. in 2004 was used to produce plastics, acrylics, adhesives and laminates used in building construction, interior decoration or furnishings and in transportation vehicle interiors.
79 percent of ALS providers indicate no Cyanide Antidote Kits are stocked on their "standard" ALS vehicles. Antidotal therapy is essential to reversing poisoning unless only mild exposure has occurred.

Rocky Mountain Poison and Drug Center Survey Results on Hospital Preparedness

In a study conducted by the Rocky Mountain Poison and Drug Center, hospitals were evaluated for preparedness to treat cyanide poisoning and data results were presented at the 2005 North American Congress of Clinical Toxicology. Findings included:

A significant difference in treatment capacities (as gauged by quantities of antidotes stocked) between various regions - with metropolitan areas in the Northeast having almost twice the capacity to treat people with cyanide poisoning as metropolitan areas in other regions.
Some hospital stocking guidelines only recommend keeping a supply of one Cyanide Antidote Kit on hand - a supply not typically considered adequate for managing multiple victims as in terrorist attacks, large structural fires or other disaster-related events.

About the Cyanide Poisoning Treatment Coalition

The Cyanide Poisoning Treatment Coalition is a 501(c)(3) non-profit made up of organizations and individuals whose members have direct involvement with the identification and treatment of cyanide exposure. Currently, there are few resources that raise awareness and educate professionals about the potential danger of cyanide exposure. Through joint strategic initiatives to focus the required attention and resources on the issues, the members of the CPTC aim to increase awareness surrounding the dangers of cyanide exposure.

About Cyanide: Toxicity and Prevalence

Cyanide is a chemical that exists in several compounds and physical forms. The gaseous form, hydrogen cyanide, is present in vehicle exhaust and tobacco smoke, and is produced during structure fires when products containing carbon and nitrogen, such as wool, paper, cotton, silk and plastics, pyrolize or incompletely burn. Inhaling smoke from one of these common building fires is likely the most common source of cyanide poisoning. Liquid forms of cyanide are one of the very few soluble compounds of gold, and thus are used in electroplating, gold mining, metallurgy and jewelry for chemical gilding, buffing, and extraction of gold. Once a person has come into contact with cyanide, it is absorbed and released into the bloodstream and enters the body cells where the cyanide disrupts the body's ability to utilize oxygen properly, even in the presence of normal oxygen levels. Unable to use oxygen, the body's cells begin to produce toxic byproducts, such as lactic acid, that ultimately kill the cells.

Cyanide poisoning is most harmful to vital organs, such as the heart and the brain, which are dependent on oxygen to function properly; therefore, the first symptoms of cyanide poisoning appear at the neurological and cardiovascular levels. At moderate to high concentrations of cyanide exposure, victims can become incapacitated within seconds, and without treatment death can occur within minutes.

Additional information on cyanide poisoning and the Cyanide Poisoning Treatment Coalition visit our Web site at www.cyanidepoisoning.org.

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