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ACUTE EXPOSURE INFORMATION

1. Potassium silver cyanide is a complex cyanide compound. It is a severe irritant of the eyes and skin, but its primary health hazard is as a CYANIDE COMPOUND. The following information pertains to the evaluation and treatment of CYANIDE POISONING.

2. Chronic occupational cyanide exposure has been associated with a variety of dermal and mucous membrane irritant complaints, usually attributed to exposure to highly alkaline aerosols or solutions of cyanide salts.
   1. True chronic cyanide toxicity in humans is rare, although a variety of complaints including goiter, subclinical thyroid disfunction, B12 and folate abnormalities, headaches, vertigo, chest discomfort, palpitations, eye and respiratory irritation, dermatitis, fatigue, poor appetite and sleeping, and epistaxis have been recorded in cyanide-exposed workers.
      1. Functional changes in hearing, loss of appetite, headache, weakness, nausea, dizziness, upper respiratory tract irritation, and dermatoses have been described in chronically exposed workers. Dermal contact with cyanide solutions can cause itching and irritation, probably because these solutions are alkaline.

3. Cyanide exposure may produce death within minutes. IMMEDIATELY BEGIN ADMINISTERING 100% OXYGEN. OBTAIN THE CYANIDE ANTIDOTE KIT AND PREPARE IT FOR USE.
   1. Lesser exposures may produce nausea, vomiting, palpitations, confusion, hyperventilation, anxiety, and vertigo. Severe hypoxic signs in the absence of cyanosis suggest the diagnosis. Patients have survived potentially lethal ingestions with supportive care only, and the absence of a rapidly deteriorating course does not exclude the diagnosis.
   2. Cyanosis is generally a late finding and does not occur until the stage of circulatory collapse and apnea. Initially the patient may experience flushing, tachycardia, tachypnea, headache, and dizziness. This may progress to agitation, stupor, coma, apnea, generalized convulsions, pulmonary edema, bradycardia, hypotension, and death.

4. Percutaneous absorption has been rarely said to result in systemic toxicity, although most such cases have involved either complete immersion in cyanide-salt solutions or large-area burns with molten cyanide.

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