When exposed to smoke, hydrogen cyanide may play a role in rendering firemen and bystanders incapable of performing self-rescue.
HCN is a toxin that spreads throughout the body; it is hazardous because it inhibits cytochrome oxidase, which stops cells from using oxygen. Loss of awareness, respiratory arrest, and finally death arise from inhibition of the last stage of electron transport in brain cells.
Higher HCN exposures cause cardiovascular collapse, tremors, cardiac arrhythmia (which may not manifest for two to three weeks after the fire exposure), coma, respiratory depression, and respiratory arrest. Inhaling minute concentrations of hydrogen cyanide can result in headaches, weakness, nausea, and vomiting. Larger doses might result in fainting, convulsions, gasping, fast pulse, irregular heartbeat, and even death. In general, the severity of the symptoms increases with the seriousness of the exposure.
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