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FIRST AID NIEASURE5(Continued) <br />NOTE: To prepare activated charcoal slurry, mix 50 grams of <br />activated charcoal in 400 mL (about 2 cups) water and mix <br />thoroughly. Give 5 mL/kg, or 350 mL for an average adult. <br />MEDICAL TREATMENT <br />EXPERIENCE SHOWS THAT FIRST AID GIVEN PROMPTLY IS USUALLY THE ONLY <br />TREATMENT NEEDED FOR TYPICAL INDUSTRIAL CYANIDE POISONING. LARGER <br />CYANIDE POISONINGS INCREASE THE NEED FOR. MEDICAL TREATMENT. <br />Do not over-react. Although prompt action is essential when <br />poisoning has occurred, a lucid, conscious person who can <br />communicate may not have signif icant cyanide poisoning and Medical <br />Treatment will rarely be necessary. "Treat what you see" is a <br />good rule of thumb. Mildly symptomatic patients who remain alert <br />may be managed by supportive care only. <br />The half-life of cyanide in the body is about 20-90 minutes. In <br />diagnosis and monitoring of patients, the critical period fior <br />treatment is short. Normally the effects from cyanide poisoning <br />occur in the first few minutes and will indicate the degree of <br />poisoning. <br />"Preventive" use of cyanide antidote in the absence of impaired <br />consciousness is not normally warranted. Keep the patient calm by <br />assurance over the next 30 minutes, and .closely monitor the <br />patient's condition. If skin contact with cyanide has been <br />prolonged and/or extensive cyanide has been ingested, watch the <br />individual closely for at least 30 minutes to assure there are no <br />efif ects from delayed absorption of cyanide into the blood stream. <br />Consider assuring intravenous access in cases where signifiicant <br />toxicity is possible. Establishment of IV access with normal <br />saline, Ringer's lactate, or other available IV fluid will <br />facilitate administration of the antidote if necessary. <br />MEDICAL TREATMENT KITS <br />Medical Treatment Kits for cyanide poisoning should be <br />conveniently located for easy access. Materials for intravenous <br />injection are intended for use only by a physician or fully <br />qualifiied medical personnel. The location of kits should pe <br />carefully planned as part of the emergency program. Kits should <br />always be taken with patient during transport to medical <br />facilities to ensure availability. Suggested locations for kits <br />include: <br />o in or near the cyanide area <br />o plant medical station <br />o guard house entrance <br />o local hospital <br />• <br />(Continued) <br />1252CR Page 7 <br />