Cardio-pulmonary arrest in acute cyanide poisoning - case report

Potassium cyanide is a highly toxic compound that interferes with cellular respiration, leading to rapid and severe poisoning. Its lethality has made it notori¬ous in suicides, homicides, and executions. The increasing accessibility of cyanide through online platforms highlights an emerging public health concern. Although infrequent, cyanide poisoning requires rapid, coordinated responses due to its acute effects. This report presents a case of cyanide poisoning in a 36-year-old woman, illustrating key clinical features and highlighting areas for improvement in emergency response protocols to support more timely, life-saving interventions. This case study highlights the tragic outcome of a woman admitted to the Emergency Department following a suicide attempt with potassium cyanide. Upon admission, the patient was resuscitated by the emergency medical team. The clinical presentation was characterized by cardio-pulmonary arrest, asystole on ECG, cherry-red skin on the head and shoulders, and dilated, unresponsive pupils. Despite medical intervention, including hydroxocobalamin and activated carbon administration, blood transfusions, and hyperkalemia treatment, the patient did not respond to resuscitation efforts. Due to prolonged CPR, the patient was disqualified from ECMO therapy, and approximately an hour after admission, her death was confirmed. Cyanide poison¬ing, while not commonly utilized in suicide attempts, presents a significant challenge in emergency medicine due to its rapid onset and lethal consequences. This case study underscores acute cyanide poisoning as a potential cause of cardiac arrest.