Problems of Forensic Sciences 2009 Vol. 80 (LXXX) 441-449
CYANIDE INTOXICATION – AN OLD ISSUE, NEW CHALLENGES
Zbigniew KOŁACIŃSKI1, 2, Konrad ŚLIWKIEWICZ1, Renata WINNICKA1, Jarosław BERENT2
1Department of Acute Intoxications, Institute of Occupational Medicine, Łódź, Poland
2Department of Forensic Medicine, Medical University, Łódź, Poland
Streszczenie
Cyanides, released during the pyrolysis of plastics, pose a lethal threat to fire victims. The dramatic clinical course of intoxication has led to a tendency throughout the world to equip medical emergency teams and even firemen with antidotes used previously only in hospital settings. Thus, the process of treatment begins at the prehospital stage. This procedure does not always save lives and, moreover, it may be an important factor in changing the kinetics of cyanides and interfering with the reliability of toxicological analysis. The presence of the antidotes themselves may significantly change the results of tests. There is an additional problem related to the direct toxicity of antidotes, which may be important when evaluating medical errors. A factor which diminishes the reliability of expert opinions is the paucity of data concerning the influence of conditions of collection and preservation of samples on the process of releasing cyanides from erythrocytes due to autolytic processes. A lack of standards in this area may lead to improper interpretation of results and imprecise or even incorrect medico-legal opinions. For reasons mentioned above, alternative methods of blood testing should be considered to assess the severity of cyanides intoxication.
Słowa kluczowe
Fire smoke; Cyanides; Pre-hospital treatment; Laboratory findings; Interfering factors; Medico-legal opinion