Laboratory
CYANIDE COMPOUNDS

Agent Overview:			Cyanide, classified as a blood agent, is a rapidly acting, potentially deadly 
				chemical that can exist in various forms. It can be a colorless gas, such as 
				hydrogen cyanide (AC) or cyanogens chloride (CK); or it can exist as a crystal 
				form, such as sodium cyanide (NaCN) or potassium cyanide (KCN). Cyanide is 
				used in the electroplating industry, in metal cleaning operations, and as an 
				industrial bug killer.

				Immediate medical attention is necessary in any suspected cyanide 
				poisoning, as well as proper use of antidote kits. Hydroxycobalamin (Vitamin B-
				12a) is used both for Vitamin B-12 deficiency and as a treatment for cyanide 
				poisoning, often in combination with sodium thiosulfate. Severe poisoning results 
				in slowed breathing (bradypnea), slowed heart rate (bradycardia), 
				cardiovascular collapse, and death. Inhalation of cyanide gas or ingestion of 
				cyanide salts can lead to lethargy or coma, sudden collapse, trouble 
				breathing (dyspnea), rapid breathing (tachypnea), increased heart rate 
				(tachycardia), and a drop in blood pressure (hypotension).

Lab Specimen Submittal:		Authorization by Dr. Jane Getchell, Director DPHL; Christina Pleasanton, 
				Deputy Director DPHL; or Tara Lydick, Chemical Terrorism Coordinator. 

Types of Specimens		Clinical Specimens: Follow CDC’s Specimen-Collection Protocol for a
Necessary for Testing:		Chemical-Exposure Event (urine: 25 mL- 50 mL in screw-cap container;
				whole blood: 3x4 mL purple top vacuum-filled (EDTA) tubes, 1x5 mL gray or 
				green top vacuum-filled tubes, 2 empty containers for each lot # submitted). 

				Environmental Samples: Collect a minimum of a pea-sized amount of material. 
				Collect solids in 50 mL centrifuge tubes and liquids in certified clean glass 
				containers. Provide empty control containers for each sample type submitted.

Packaging Instructions:		Clinical Specimens: Ship to DPHL as a Biological Substance, Category B 
				(Packing Instruction 650). Freeze urine specimen on collection, ship on dry 
				ice. Refrigerate whole blood specimens on collection, but do not freeze.

				Environmental Samples: Place the packaged sample containers in a secondary 
				unbreakable container.

				All: Use a minimum of two layers of initialed and dated tamper-proof, waterproof 
				forensic evidence tape for each submission. Avoid covering the sample labels.

Receiving Specimens		Authorized specimens are received at the rear (loading dock) entrance of 
at DPHL:			the laboratory. Submitters must present ID and have proper forms completed.

Handling of Specimens:		Chain of custody procedures must be followed. Chain of Custody and 
				Request for Testing Forms are required for all specimens.

Reporting Results:		DPHL is a Cyanide Qualified Laboratory. Testing personnel will notify 
				supervisor or Laboratory Director, Deputy Laboratory Director or Chemical 
				Terrorism Coordinator. The Information Call Log and Information and Information 
				Form will provide information for testing results notification outside of the DPHL.

Contact Information:		Jane Getchell, DrPH, DPHL Director: 302-223-1520 (24/7 coverage).



24/7 Emergency Contact Number:  1-888-295-5156
Revised: 05/2010