Cyanide self-poisoning

Four cases of cyanide self-poisoning were admitted to one hospital over a period of two years. Two of the patients died. The diagnosis in the unconscious patient may be suggested by the finding of bradycardia and the absence of cyanosis (despite inadequate ventilation). The diagnosis can be confirmed in 5 to 10 minutes by a simple test on gastric aspirate, performed by the casualty officer. Cardiac pacing was used in two patients and may have a place in the supportive management of severe cases.