CYANIDE

Test Documentation
Specimen Required
Draw blood in a green sodium or lithium heparin tube. Send 4.0 mL whole blood (3.0 mL minimum) room temperature. Do not open tube. Do not freeze or refrigerate. Sample should arrive at Warde Medical Laboratory the day of collection.
No laboratory test is available to assess cyanide toxicity in a patient who is on nitroprusside therapy; this test should not be ordered when the patient is on nitroprusside. However, thiocynate toxicity may occur with long-term nitroprusside use (longer then seven to fourteen days with normal renal function and three to six days with renal impairment at greater than 2 µg/kg/min infusion rates). Thiocyanate levels may be monitored on an every other day basis to assess potential thiocyanate toxicity and to indicate possible adjustments in dosage.

Alternate Specimen
Whole blood: Lavender EDTA

Rejection Criteria
Clotted or hemolyzed samples

Methodology
Quantitative: Colorimetric

Stability
Room Temperature: 72 hours; if tightly capped; Refrigerated: Unacceptable; Frozen: Unacceptable

Reference Range
Non-smokers:   Less than 20 µg/dL  
Smokers:   Less than 40 µg/dL  
Toxic Level:Greater than 100 µg/dL

Performed
Sunday, Wednesday, Friday

Turnaround Time3-6 days
Test CodeCYAN
CPT-4 Code (s)
82600
LOINC Codes
5634-1

Warde
Medical
Laboratory