2012-02-28_REVISION - M1980244 (84)

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MATERIAL SAFETY DATA SHEET Cyanco® Sodium Cyanide, Bricks 98/99 % Material no. Version 1.6 / US Specification 166161 Revision date 09/16/2009 Print Date 09/16/2009 Order Number Page 4 / 15 cyanco The rescuer or medical responder should first of all protect themselves from exposure. Decontaminate the victim to prevent further absorption and exposure to rescuers. Monitor vital signs. 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. NOTE: 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! Mild poisoning Treatment is dependant on clinical presentation with symptoms and history of exposure (related to dose). 100% oxygen 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. 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) If the treating physician is not familiar with cyanide exposure and treatment, they should contact the medical division of their regional poison control centers for immediate assistance with additional information as needed. For all cyanide exposure: All cyanide exposed persons should undergo continued monitoring for several hours, even if patient feels well to ensure there are no residual or recurrent poisoning symptoms. Severe poisoning Artificial respiration with 100% oxygen. Immediate antidote administration with the legal antidote for the country of the exposure. Listed below are the two most commonly used antidotes: 1. Methemoglobin- forming agent Nitrite Therapy: (amyl nitrite, sodium nitrite and sodium thiosulfate) (commonly referred to as the Taylor, Lilly or Pasadena Cyanide Antidote Kit). For moderate to severe exposures (patient still conscious) Amyl Nitrite Aspirols: (1 -3 aspirols administered as an inhalant, held 1 -2 inches under the nose for 15- 30 seconds, and then remove for 15 -30 seconds) (read medication information insert prior to administering). 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. 2. Complexing antidote agent: Hydroxycobalamin (commonly known as the Cyanokit) Treatment as follows: Administer hydroxocobalamin (Cyanokit ®) 5 g i.v. (70 mg /kg b.w. in adults) by infusion 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 hydroxocobalamine is intravenously. (The physician should read the medication package information carefully to ensure proper reconstitution to liquid state and administration of antidote!). 5. FIRE - FIGHTING MEASURES M5054/5 (P271001) 1911812009 7:45