Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 23 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Cyanide: Homicide Module Four – Cyanide & Fumigants 23 Given its reputation and availability via the Internet, cyanide is a common weapon of choice for many would-be poisoners. In the story described on this slide, an 18 year old Maryland teen purchased 2 grams of potassium cyanide on the internet using his mother’s credit card. He poisoned and killed his best friend because of rivalry over a former girlfriend. The compound was administered by lacing his friend’s beverage while the two were playing video games. December 2008 Version 2.0 Page 210
Chemical Agents of Opportunity for Terrorism Training Support Package Participant Guide Slide 24 Chemical Agents of Opportunity for Terrorism: TICs & TIMs Cyanide: Homicide Timeline: • 17 yr old male drinks KCN spiked soda • Feels unwell and goes to the bathroom • Emerges from the bathroom and collapses • EMS intubate for apnea. Vital signs present. • Cardiac arrest in hospital. ACLS and recovery. • Transfer to tertiary care center. • Dx made. Steps 2 & 3 of antidote kit administered. • No neurologic recovery. Module Four – Cyanide & Fumigants 24 This slide provides a timeline of events for the case study described on the previous slide. An indeterminate period after ingesting the cyanide spiked soda provided by his friend, the subject reported feeling unwell. Upon emerging from the bathroom the subject collapsed and emergency services were called. EMS responders intubated the subject due to the appearance of apnea (respiratory arrest) and determined that vital signs were present. While cyanide poisoning was not yet suspected, the patient was hospitalized and underwent standard testing. While in the Radiology suite for a CT scan, the subject went into cardiac arrest necessitating ACLS (Advanced Cardiac Life Support). The subject recovered and was subsequently transferred to a tertiary care center. A diagnosis of cyanide poisoning was reached and antidote steps 2 and 3 were administered. No neurologic recovery was noted. The victim went into respiratory arrest and died soon after. The antidote kit has 3 parts. Part 2 is sodium nitrite, given IV, and part 3 is sodium thiosulfate, also given IV. Part 1, not used in this case, is amyl nitrite, given by inhalation. Details about treatment for cyanide poisoning will be covered in subsequent slides. December 2008 Version 2.0 Page 211
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Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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