Cyanide Kit
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Introduction
contains Sodium nitrite and Sodium thiosulphate injectable solution and amyl nitrite (0.3 ml) crushable ampules for inhalation.
* They oxidize hemoglobin to methemoglobin, which binds the cyanide to form nontoxic cyanmethemoglobin.
* Inhalation of an ampule of amyl nitrite produces a methemoglobin level of 5%.
* Intravenous administration of a single dose of sodium nitrite is anticipated to produce a methemoglobin level of about 20-30%.
Dosage and Method of Administration
- Amyl Nitrite is administered by inhalation for up to 30 seconds every 2 to 3 minutes. Up to 6 ampules can be used.
- Amyl nitrite is followed by infusion of 300 mg/10 ml or 10 mg/kg IV sodium nitrite, over 2-5 minutes.
- Then inject 12.5 g/50 ml sodium thiosulfate IV over 10 minutes PRN; may repeat both injections at 1/2 original dose (If signs of cyanide poisoning reappear).
Antidotes should be administered in patients who are clinically symptomatic (i.e., unstable vital signs, acidosis, impaired consciousness, seizures, or coma).