Agent Identification - Chemical
Blood agents such as cyanide have a rapid onset of symptoms and have an odor of bitter almonds. However, a significant percent of the population is unable to smell almonds decreasing one of the indicators of cyanide exposed environment. Symptoms begin with flushing, gasping followed by choking, asphyxia, seizures and death. The single most important initial treatment is removal from the contaminated environment and further exposure followed by the rapid administration of a cyanide antidote kit. While cyanide kits are not commonly found in multiple numbers in many rural EMS agencies or hospital Emergency Departments, recent literature is growing with the use of I.V. hydroxocobalamin at fireground scenes in Europe for the treatment of smoke inhalation caused cyanide toxicity of firefighters.