AKA Hydrocyanic acid, Formonitrile, Prussic acid
Mimics carbon monoxide poisoning
Smell of bitter almonds but not all people can smell cyanide
Absorbed through skin, inhaled or ingested
Can affect individuals near fire with synthetic materials or plastics
Can penetrate rubber and barrier fabrics
Cyanide inhibits cytochrome oxidase on mitochondria
Cells unable to use oxygen in bloodstream
Cellular asphyxiation
Symptoms can be delayed up to 60 minutes
Symptoms dependent on concentration, form of cyanide, and route of exposure
CNS and cardiovascular system most susceptible
Initially hypertension and tachycardia progressing to bradycardia, hypotension, and arrhythmias late
Anxiety, dizziness, headache, apnea, seizures, and coma
100% oxygen and antidote therapy
Sodium nitrite (IV) or amyl nitrite (inhaled) to displace cyanide from cytochrome oxidase
Sodium thiosulfate: For conversion of cyanide to excretable thiosulfate
Repeat sodium nitrite and sodium thiosulfate in 30min at half initial dose if needed
Hydroxocobalamin (Vit B12a): makes CN water soluble and non-toxic
Cyanide Antidote Kit: Amyl nitrite pearls, sodium nitrite (IV), sodium thiosulfate (IV)
Cyanokit: Less toxic than cyanide antidote kit and shown effective in cardiac arrest
Chemical weapons
Radiation exposure 
Caustic cocktail
Dirty bomb
Bioterrorism
Care under fire
Mass shooting
Hazmat exposure