N.J. Admin. Code § 8:41-7.21

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:41-7.21 - Standing orders for cyanide poisoning (optional, at medical director$DQ$s discretion)

(a) The following standing orders (optional, at the medical director's discretion) are authorized in the event that an adult patient presents with cyanide poisoning:

1. Do not enter or attempt to rescue a person in an area suspected or documented to be contaminated with cyanide poison;

2. Before making patient contact, ensure that appropriate decontamination has been performed;

i. If the patient has been exposed to liquid cyanide, ensure that all of the patient's clothing has been removed;

ii. No decontamination is needed for pure vapor exposure;

3. Determine the level of exposure;

i. If the level of exposure is mild (that is, the patient is conscious and breathing):

(1) Assess and secure the airway;

(2) Administer high concentration oxygen; and

(3) Observe the patient for respiratory distress;

ii. If the level of exposure is severe (that is, the patient is unconscious or if respirations are severely compromised):

(1) Assess and secure the airway;

(2) Administer high concentration oxygen;

(3) Provide suctioning (if necessary);

(4) If Cyanide kit is available, break and hold an aspirol of Amyl Nitrite in front of the patient's nose for 15 seconds, followed by removal for 15 seconds; use a new aspirol of Amyl Nitrite approximately every three minutes thereafter until IV access has been established. If the patient is unconscious, place the aspirol of Amyl Nitrite in the mask of the bag-valve-mask device or in the bag-valve-mask device itself;

(5) Establish IV access;

(6) Administer Sodium Thiosulfate 12.5 grams IV; and

4. Contact the medical command physician.

N.J. Admin. Code § 8:41-7.21