SUICIDE WITH HYDROGEN CYANIDE, A NOTORIOUS CHEMICAL AGENT: A CASE REPORT
Journal Title: Journal of Paramedic and Emergency Health Services - Year 2020, Vol 1, Issue 1
Abstract
Hydrogen Cyanide (HCN) is called a blood poisoning agent because it impairs the oxygen-carrying capacity of erythrocytes. Although Hydrogen Cyanide poisoning is rare, its mortality is high. Since HCN poisoning is also through contact, it can cause poisoning of health professionals. Therefore, EMS professionals should always take the necessary measures when treating patients. In this study, a 27-year-old patient who was found in a hotel room in Ankara by the staff and reported to EMS was evaluated. Two ambulance teams (one paramedic-administrated, one physician-administrated) were assigned to the scene. The patient had a Glasgow Coma Scale of 3, fixed and dilated pupils, rigor mortis, but no respiration and no circulation. During the skin examination, it was determined that the patient's face and chest were in cherry red color. There was note at the scene saying "Danger of cyanide. Do not enter in!". The team did not notice the note when entering the scene, but after they have noticed they left the room and waited in the safe area. In HCN intoxications, a cherry red skin is observed due to high venous hemoglobin oxygen saturation. However, this is rare in clinical observations. The patient in our study had redness on the face and chest. There may be a bitter almond smell in the victim's breath and at the scene. However, only 60-80% of people can smell this due to genetic variations. In this case, the ambulance team could not smell this bitter almond smell specific to HCN. EMS professionals may be exposed directly to the toxic substance at the scene. Therefore, EMS professionals should be able to control the crime scene, take detailed patient history, be aware of the signs and symptoms of CBRN agents, and take the necessary measures.
Authors and Affiliations
Burhan ALBAY, Burak BEKGÖZ, İshak ŞAN, Eren USUL, Hakan CENCİ
Keywords
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- EP ID EP690890
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SUICIDE WITH HYDROGEN CYANIDE, A NOTORIOUS CHEMICAL AGENT: A CASE REPORT
Hydrogen Cyanide (HCN) is called a blood poisoning agent because it impairs the oxygen-carrying capacity of erythrocytes. Although Hydrogen Cyanide poisoning is rare, its mortality is high. Since HCN poisoning is also th...