1. Homicide with intramuscular cyanide injection: a case report.
- Author
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Tobarran, Natasha, Kershner, Emily K., Cumpston, Kirk L., Rose, S. Rutherfoord, and Wills, Brandon K.
- Subjects
INTRAMUSCULAR injections ,HOMICIDE ,CYANIDE poisoning ,CYANIDES ,TRACHEA intubation ,VITAL signs - Abstract
Cyanide poisoning most commonly occurs from smoke inhalation, less commonly by oral ingestion for suicide or homicide. There are rare cases of intravenous or subcutaneous parenteral cyanide. We report a fatal case of intramuscular cyanide used as a homicidal agent. A 35-year-old female was assaulted and injected with an unknown substance in her left buttock using a syringe. She was unresponsive at ED arrival and underwent immediate endotracheal intubation. After near normal vital signs at arrival (BP 130/83 mmHg, HR 102 bpm), she rapidly became hypotensive and bradycardic with worsening acidosis (pH 6.95, lactate 7.7 mmol/L). Despite vasopressors, hydroxocobalamin, and sodium thiosulfate, she succumbed. Plasma cyanide concentrations from blood drawn 1 and 4 h post exposure were both in the lethal range (3.4 and 4.1 mg/L, respectively). Our case demonstrates that intramuscular injection can result in fatal cyanide poisoning, resulting in rapid absorption, severe toxicity, and death. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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