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FIRST AID MEASURES(continued) <br />• <br />o doctor's office and residence <br />CAUTION: Avoid storing amyl nitrite or Medical Treatment Kits in <br />areas subject to extreme heat or freezing conditions. Kits and <br />amyl nitrite should be accessible but secured against tampering. <br />They should be inspected regularly and the amyl nitrite ampoules <br />replaced every 1-2 years (See First Aid Supplies Section.). <br />Medical Treatment Kits should, contain the following: <br />• <br />1. One box containing one dozen (12) amyl nitrite ampoules. <br />2. Two sterile ampoules of sodium nitrite solution (10 mL of a 30 <br />solution in each). <br />3. Two sterile arpoules of sodium thiosulfate solution (50 mL of a <br />25 o solution in each.) . <br />4. One 10 mL sterile syringe. One 50 mL sterile syringe. Two <br />sterile intravenous needles. One tourniquet. <br />5. One dozen gauze pads. <br />6. Latex gloves. <br />7. A "Biohazard" bag fior disposal ofi bloody/contaminated equipment. <br />.8. A set of cyanide instructions on first aid and medical <br />treatment. <br />NOTE: Amyl nitrite ampoules and Medical Treatment Supplies can be <br />purchased through local pharmacies with a physician's prescription. <br />MEDICAL TREATMENT PROCEDURE <br />1. Sodium nitrite: Adult - 10 mL of 3% solution (300 mg) <br />Draw solution from the ampoule and inject slowly over 4-5 minutes <br />(2 to 2.5 mL/minute). As soon as practical, monitor blood <br />pressure .and continue checking pulse. Slow the rate ofi injection <br />if hypotension (low blood pressure) occurs. <br />2. Sodium thiosulfate: Adult - 50 mL of 25% solution (12.5 grams) <br />Follow sodium nitrite with sodium thiosulfate injected at a rate <br />of 2.5 mL/minute (10-20 minutes). <br />The total time for injection ofi these initial doses of both <br />components at the recommended rates is lengthy., approximately <br />20-25 minutes. <br />Consider the body weight and condition of the patient when <br />treating a cyanide exposed patient with sodium nitrite. Both amyl <br />nitrite and sodium nitrite produce methemoglobin, which reduces. <br />the oxygen carrying capacity of the blood. Methemoglobinemia is <br />potentially harmful when methemoglobin levels exceed 20-30a (See <br />(Continued) <br />• <br />1252CR Page 8 <br />