An incident of hydrogen cyanide poisoning

Seven cases of hydrogen cyanide gas poisoning which occurred in an industri al building in Hong Kong are presented here. Two of them were more severely injured and required specific antidotal treatment. The other five were mil d and responded to supportive treatment alone. All except one patient recov ered completely. Cyanide poisoning is relatively uncommon in urbanized area , so high index of suspicion is important for early diagnosis and treatment . We believe that prevention of cyanide poisoning can be achieved by proper storage of chemicals, and by enforcing rescuers to wear special chemical p rotective clothing to avoid systemic poisoning because of dermal absorption of hydrogen cyanide gas. As there are newer and safer cyanide antidotes av ailable, each emergency department should have a stock of updated products such as hydroxocobalamin. (Am J Emerg Med 2000;18:172-175, Copyright (C) 20 00 by W.B. Saunders Company).