2019-12-13_REVISION - M1980244 (60)

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cyan r co SAFETY DATA SHEET cyan CYANCOO SODIUM CYANIDE SOLUTION, MINING QUALITY 23-32% BY WT. Version 3.0 US Print Date: 2/1/2016 Cardiovascular Symptoms Early Stage:• hypertension•sinus arrhythmia•atrioventricular arrhythmia • bradycardia Advanced Stage:•tachycardia• complex arrhythmia•cardiac arrest Skin Symptoms Early Stage: • rosy skin color Advanced Stage: •cyanosis Effect on the Metabolism Lactate acidosis: pH 7.1 and lactate level of 17 mmol/I are described. Treatment The treatment advice may vary by region. Contact a regional poison control center for appropriate antidote treatment used in your region. CAUTION: This is an outline of antidotes available for informational purposes. It is important for the treating physician to be familiar with the administration of cyanide antidotes available in the country where the chemical is being used! Rapid treatment with appropriate antidote therapy is essential to saving lives during a high dose acute exposure to cyanide. NOTE: Removal of toxic substance has equal importance to implementation of antidote therapy. Mild Poisoning •Treatment is dependent on clinical presentation with symptoms and history of exposure (related to dose). • 100%oxygen (medical grade)and artificial respiration if indicated. • Closely monitor patient and their vital signs(blood pressure, pulse and respirations). • Monitor the patient for onset of symptoms or deterioration of status. • Depending on the pathology and clinical findings, based on strictly monitored controls of the clinical findings, it may be necessary for the physician to implement symptom-oriented treatment for pulmonary edema prophylaxis. •X-rays of the lungs may be necessary for pulmonary edema diagnosis. Severe Poisoning • Specific antidote treatment can be indicated for moderate to severe cyanide intoxication. • It is important to know that there are several different types of antidotes available for treatment of cyanide intoxication in different countries. For All Cyanide •All cyanide exposed persons should undergo continued monitoring for several hours, Exposure even if patient feels well to ensure there are no residual or recurrent poisoning symptoms. •Artificial respiration with 100%oxygen (medical grade). • Immediate antidote administration with the legal antidote for the country of the exposure. Commonly Used Antidotes Met hemoglobin-Forming Agent Nitrite Therapy: amyl nitrite, sodium nitrite, sodium thiosulfate. For Moderate to Amyl Nitrite Aspirols: 1-3 aspirols administered as an inhalant, held 1-2 inches under the Severe Exposures nose for 15 seconds, and then remove for 15 seconds. Read medication information (patient still insert prior to administering. conscious) Sodium nitrite 300-600 mg administered intravenously over a period of 5 to 15 minutes. Sodium thiosulfate(12.5 g- 100-500 mg/kg weight) intravenously over a period of 15-20 minutes. If patient is conscious,then sodium thiosulfate may be administered as an antidote by itself: (See antidote package information insert) Sodium thiosulfate(12.5 g- 100-500 mg/kg weight) IV may be administered depending on the clinical presentation and symptoms. Complexing Antidote Agent Hydroxocobalamin-commonly known as the Cyanokit@. Treatment as Administer hydroxocobalamin (Cyanokit@) 5 g i.v. (70 mg/kg b.w. in adults)by infusion Follows: over a period of 20-30 minutes. Administration of this dose can be repeated as required depending on the severity of poisoning. Infusion time for repeated dose: 30 minutes to 2 hours. The only permissible route of administration for hydroxocobalamin is intravenously. The physician should read the medication package information carefully to ensure proper reconstitution to liquid state and administration of antidote! Page 3 of 10