1995-08-11_REVISION - M1977493 (8)

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FMT AID(continued) Treatment for cyanide poisoning can be provided in two ways, "First Aid" and "Medical Treatment". Both require immediate action to prevent further harm or death. First aid using oxygen and amyl nitrite can be given by a layperson before trained medical help arrives. Medical treatment may require intravenous injections of sodium nitrite and sodium thiosulfate, and must be administered by qualified medical personnel. Even if a doctor or nurse is present, the need for fast treatment dictates using first aid treatment with oxygen and amyl nitrite while medical treatment materials for intravenous injection are being prepared. Experience shows that first aid given promptly is usually the only treatment needed for typical accidental poisonings. Larger cyanide exposure increases the need for medical treatment. Medical treatment with standard intravenous doses of sodium nitrite followed by sodium thiosulfate is reserved for patients who do not regain clear consciousness with oxygen and amyl nitrite. However, even under optimum conditions, amyl nitrite can be administered faster and should be used even if medical treatment follows. Any site where cyanide is handled should always stock the materials listed for First Aid supplies and Medical Treatment Kits. Identification of community hospital resources and emergency medical squads in order to equip and train them prior to an exposure is essential. All employees who will work with cyanide must be trained, and routinely practice rescue and first aid actions for cyanide exposures. In case of cyanide poisoning, start first aid treatment • immediately, then call a physician. FIRST AID SUPPLIES Adequate first aid supplies for cyanide poisoning should be conveniently placed throughout cyanide areas and should be immediately accessible at all times. They should be routinely inspected (typically daily) by people who would use them in an emergency. The total number of each item listed below should be adequate to handle the largest number of exposure cases reasonably anticipated, taking into account that some supplies may be wasted, destroyed, or inaccessible in the emergency. 1. Oxygen Resuscitators - The Flynn Series III Model by O-Two Systems (800-387-3405) has performed well in DuPont use. It is lightweight, rugged, and easy to use. 2. Amyl Nitrite Ampules (antidote) - One box of one dozen ampules per station is usually satisfactory. Locate stations throughout the cyanide area. CAUTION: Amyl nitrite is not stable and must be replaced every 1 to 2 years. Store in the original dated box, away from heat. A common DuPont practice is to use the resuscitator as the storage point for the amyl nitrite ampules. Avoid storage on vehicles where temperatures can reach 60-66 deg C (140-150 deg F) or more. Storage (continued) • 1252CR Page 5