Chemical Agents of Opportunity for Terrorism: TICs & TIMs

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