Chemical Agents of Opportunity for Terrorism: TICs & TIMs

Chemical Agents of Opportunity for Terrorism
Training Support Package
Participant Guide
Slide 12
Chemical Agents of Opportunity for Terrorism:
TICs & TIMs
Cyanide: Clinical Manifestations
• “Gasp poison”
• Central Nervous System
– Headache, confusion, agitation, syncope, convulsions,
coma, death
• Cardiovascular
– Tachycardia, hypertension
– Bradycardia, hypotension
– Cardiac arrest
• GI
– nausea, vomiting, abdominal pain
Module Four – Cyanide & Fumigants
12
Cyanide is a systemic poison; there is no specific target organ. It is sometimes called a
“blood agent” because it is carried by the blood for distribution to the body. As a result
there is no reliable clinical “toxidrome” for low level cyanide poisoning; no specific
constellation of signs and symptoms. The heart and central nervous system are
generally most susceptible because they are the most oxygen-sensitive organs. Thus at
high level exposures, coma and cardiac arrest make up the toxidrome. The word gasp
poison suggests that when inhaled the onset is very rapid that the victim literally gasps
for breath.
CNS manifestations include syncope, or loss of consciousness, which rapidly resolves,
though most of the time the patient does not rapidly recover and remains comatose.
Cardiovascular manifestations include rapid (tachycardia) and (bradycardia), slow heart
rates as well as high (hypertension) and low (hypotension) blood pressures.
The term "blood agent" is a misnomer because these agents do not really affect the
blood. Blood agents may act upon all tissues in the body once distributed by the blood.
December 2008 Version 2.0 Page 199