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Serious vitamin B-12 deficiency may result in anemia, stomach problems, and nerve damage

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The following should be undertaken: (a) Trained personnel (wearing appropriate protective clothing and breathing apparatus if hydrogen cyanide or liquid cyanide preparations are involved) should * terminate further exposure * commence artificial ventilation with 100% oxygen a * administer 0.2-0.4 ml amyl nitrite via Ambu bag (b) A physician (if immediately present on the scene) should * terminate further exposure * artificial ventilation with 100% oxygen a * administer 0.2-0.4 ml amyl nitrite via Ambu bag In cases of unequivocal moderate to severe poisoning, the above procedure should be followed by 50 ml of 25% sodium thiosulfate solution (12.5 g) i.v

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