Strychnine: Biotoxin

Colorless, transparent crystals or white, crystalline powder.

Strychnine is a toxic alkaloid derived from the seeds of the trees Strychnos nux vomica, Strychnos ignatii (S. sancta Ingnatius), and Strychnos tiente (Upas tree), that can be found in India, southern Asia, northern Australia, and Hawaii. It was widely used in poison (toxic) baits to kill rodents and other mammals and is a common adulterant of many illicit (street) drugs. Exposure to strychnine can be fatal. It is odorless and has a bitter taste.

• Indoor Air: Strychnine can be released into indoor air as fine particles (aerosol).
• Water: Strychnine can be used to contaminate water.
• Food: Strychnine can be used to contaminate food.
• Outdoor Air: Strychnine can be released into outdoor air as fine particles (aerosol).
• Agricultural: If strychnine is released into the air as fine particles (aerosol), it has the potential to contaminate agricultural products.

Strychnine can be absorbed into the body by inhalation or ingestion. It can also be injected into the body when mixed with a liquid.

First Responders should use a NIOSH-certified Chemical, Biological, Radiological, Nuclear (CBRN) Self Contained Breathing Apparatus (SCBA) with a Level A protective suit when entering an area with an unknown contaminant or when entering an area where the concentration of the contaminant is unknown. Level A protection should be used until monitoring results confirm the contaminant and the concentration of the contaminant.
NOTE: Safe use of protective clothing and equipment requires specific skills developed through training and experience.

Select when the greatest level of skin, respiratory, and eye protection is required. This is the maximum protection for workers in danger of exposure to unknown chemical hazards or levels above the IDLH or greater than the AEGL-2.

• A NIOSH-certified CBRN full-face-piece SCBA operated in a pressure-demand mode or a pressure-demand supplied air hose respirator with an auxiliary escape bottle.
• A Totally-Encapsulating Chemical Protective (TECP) suit that provides protection against CBRN agents.
• Chemical-resistant gloves (outer).
• Chemical-resistant gloves (inner).
• Chemical-resistant boots with a steel toe and shank.
• Coveralls, long underwear, and a hard hat worn under the TECP suit are optional items.

Select when the highest level of respiratory protection is necessary but a lesser level of skin protection is required. This is the minimum protection for workers in danger of exposure to unknown chemical hazards or levels above the IDLH or greater than AEGL-2. It differs from Level A in that it incorporates a non-encapsulating, splash-protective, chemical-resistant splash suit that provides Level A protection against liquids but is not airtight.

• A NIOSH-certified CBRN full-face-piece SCBA operated in a pressure-demand mode or a pressure-demand supplied air hose respirator with an auxiliary escape bottle.
• A hooded chemical-resistant suit that provides protection against CBRN agents.
• Chemical-resistant gloves (outer).
• Chemical-resistant gloves (inner).
• Chemical-resistant boots with a steel toe and shank.
• Coveralls, long underwear, a hard hat worn under the chemical-resistant suit, and chemical-resistant disposable boot-covers worn over the chemical-resistant suit are optional items.

Select when the contaminant and concentration of the contaminant are known and the respiratory protection criteria factors for using Air Purifying Respirators (APR) or Powered Air Purifying Respirators (PAPR) are met. This level is appropriate when decontaminating patient/victims.

• A NIOSH-certified CBRN tight-fitting APR with a canister-type gas mask or CBRN PAPR for air levels greater than AEGL-2.
• A NIOSH-certified CBRN PAPR with a loose-fitting face-piece, hood, or helmet and a filter or a combination organic vapor, acid gas, and particulate cartridge/filter combination or a continuous flow respirator for air levels greater than AEGL-1.
• A hooded chemical-resistant suit that provides protection against CBRN agents.
• Chemical-resistant gloves (outer).
• Chemical-resistant gloves (inner).
• Chemical-resistant boots with a steel toe and shank.
• Escape mask, face shield, coveralls, long underwear, a hard hat worn under the chemical-resistant suit, and chemical-resistant disposable boot-covers worn over the chemical-resistant suit are optional items.

Select when the contaminant and concentration of the contaminant are known and the concentration is below the appropriate occupational exposure limit or less than AEGL-1 for the stated duration times.

• Limited to coveralls or other work clothes, boots, and gloves.

• Strychnine decomposes on heating, producing toxic fumes, including nitrogen oxides.
• Strychnine is incompatible with strong oxidants.

• Upper and lower explosive (flammable) limits in air are not available for strychnine.

• Strychnine is combustible.
• Strychnine is difficult to ignite.
• Strychnine decomposes on heating, producing toxic fumes including nitrogen oxides.
• For small fires, use dry chemical, carbon dioxide, or water spray.
• For large fires, use water spray, fog, or regular foam.
• Dike fire control water for later disposal; do not scatter the material.
• Use water spray or fog; do not use straight streams.

• If a tank, rail car, or tank truck is involved in a fire, isolate it for 0.5 mi (800 m) in all directions; also consider initial evacuation for 0.5 mi (800 m) in all directions.
• This agent is not included in the DOT ERG 2004 Table of Initial Isolation and Protective Action Distances.
• In the DOT ERG 2004 orange-bordered section of the guidebook, there are public safety recommendations to isolate a strychnine (Guide 151) spill or leak area immediately for at least 150 ft (50 m) for liquids and 75 ft (25 m) for solids in all directions.

• Not established/determined

• OSHA: Not established/determined
• NIOSH: 5016

• AIR MATRIX
  NIOSH [1994]. Strychnine: Method 5016. In: NIOSH Manual of Analytical Methods. 4th ed. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 94-113.
• OTHER
  Braselton WE, Johnson M [2003]. Thin layer chromatography convulsant screen extended by gas chromatography-mass spectrometry. J Vet Diagn Invest 15(1):42-45.Kelly KL, Johnston JJ [1995]. Supercritical-fluid extraction of strychnine using 2 different sequential organic modifiers. J Agr Food Chem 43(5):1208-1211.

Zong YY, Che CT [1995]. Determination of strychnine and brucine by capillary zone electrophoresis. Planta Med 61(5):456-458.

• SOIL MATRIX
  No references were identified for this sampling matrix for this agent.
• SURFACES
  No references were identified for this sampling matrix for this agent.
• WATER
  No references were identified for this sampling matrix for this agent.

Generalized muscle spasms may occur within 5 minutes of inhalation, or intravenous administration, and within 15 minutes of ingestion but may take as long as 60 minutes to appear. Exposure to high levels of strychnine may result in respiratory failure possibly leading to death, and brain death within 15 to 30 minutes following exposure. Seizures may occur within 15 minutes following exposure and generally subside 12 to 24 hours following ingestion. If the patient can be supported for the first 6 to 12 hours, the prognosis is good.

Strychnine is rapidly absorbed after ingestion, inhalation, or intravenous (IV) administration. It causes generalized muscle spasms, muscle cramps, stiffness and tightness, agitation, heightened awareness and responsiveness, respiratory failure, stimulation sensitive seizures, and possibly death.

• Not established/determined

• Possible early adverse effects indicative of strychnine toxicity (prodrome): muscle cramps (especially of the neck and back), stiffness and tightness, agitation, heightened sensory awareness and responsiveness.
• Prominent characteristic adverse health effects of strychnine toxicity are painful generalized muscle spasms and seizure. Spasms and seizures are often precipitated by sensory stimulation (sound, touch, and vision). Patient/victims remain alert and lucid during seizures. Seizures may cause hyperthermia, metabolic and respiratory acidosis, destruction of skeletal muscle at the molecular level (rhabdomyolysis), and kidney failure due to the release of muscle protein (myoglobinuric renal failure). Convulsions may be accompanied by abnormal pupil dilation (mydriasis), eye protrusion (ocular proptosis), and rapid uncontrollable eye movements (nystagmus).
• Other adverse health effects include fast heart rate (tachycardia), high blood pressure (hypertension), rapid breathing (tachypnea), blood electrolyte and mineral disturbances, an increase of white blood cells (leukocytosis), perspiration (diaphoresis), blue discoloration of the skin due to lack of oxygen (cyanosis), jaw closure due to muscle spasms (trismus), facial muscle spasms (risus sardonicus), and spasm of the muscles of the back, causing the head and lower limbs to bend backward and the trunk to arch forward (opisthotonus). Vomiting and nausea occur rarely.
• Death may occur due to respiratory failure, cardiac arrest, brain damage, or multi-organ failure.

• See Ingestion Exposure.

• See Ingestion Exposure.

The purpose of decontamination is to make an individual and/or their equipment safe by physically removing toxic substances quickly and effectively. Care should be taken during decontamination, because absorbed agent can be released from clothing and skin as a gas. Your Incident Commander will provide you with decontaminants specific for the agent released or the agent believed to have been released.

The following are recommendations to protect the first responders from the release area:

• Position the decontamination corridor upwind and uphill of the hot zone. The warm zone should include two decontamination corridors. One decontamination corridor is used to enter the warm zone and the other for exiting the warm zone into the cold zone. The decontamination zone for exiting should be upwind and uphill from the zone used to enter.
• Decontamination area workers should wear appropriate PPE. See the PPE section of this card for detailed information.
• A solution of detergent and water (which should have a pH value of at least 8 but should not exceed a pH value of 10.5) should be available for use in decontamination procedures. Soft brushes should be available to remove contamination from the PPE. Labeled, durable 6-mil polyethylene bags should be available for disposal of contaminated PPE.

The following methods can be used to decontaminate an individual:

• Decontamination of First Responder:
  • Begin washing PPE of the first responder using soap and water solution and a soft brush. Always move in a downward motion (from head to toe). Make sure to get into all areas, especially folds in the clothing. Wash and rinse (using cold or warm water) until the contaminant is thoroughly removed.
  • Remove PPE by rolling downward (from head to toe) and avoid pulling PPE off over the head. Remove the SCBA after other PPE has been removed.
  • Place all PPE in labeled durable 6-mil polyethylene bags.
• Decontamination of Patient/Victim:
  • Remove the patient/victim from the contaminated area and into the decontamination corridor.
  • Remove all clothing (at least down to their undergarments) and place the clothing in a labeled durable 6-mil polyethylene bag.
  • Thoroughly wash and rinse (using cold or warm water) the contaminated skin of the patient/victim using a soap and water solution. Be careful not to break the patient/victim’s skin during the decontamination process, and cover all open wounds.
  • Cover the patient/victim to prevent shock and loss of body heat.
  • Move the patient/victim to an area where emergency medical treatment can be provided.

Initial treatment is primarily supportive.

There is no antidote for strychnine toxicity.

• Immediately remove the patient/victim from the source of exposure.
• Immediately wash eyes with large amounts of tepid water for at least 15 minutes.
• Seek medical attention immediately.

• Immediately remove the patient/victim from the source of exposure.
• Ensure that the patient/victim has an unobstructed airway.
• Do not induce vomiting (emesis).
• Once the airway is secured and neuromuscular activity is controlled, administer charcoal as a slurry (240 mL water/30 g charcoal). Usual dose: 25 to 100 g in adults/adolescents, 25 to 50 g in children (1 to 12 years), and 1 g/kg in infants less than 1 year old.
• Treat muscle spasms with diazepam (or other benzodiazepine) under a physician’s direction or per local EMS protocol.
• If muscle spasms cannot be controlled or recur, administer phenobarbital.
• Avoid unnecessary stimulation, which may precipitate additional muscle spasms.
• Administer supplemental oxygen and assist ventilation as needed.
• For exceptionally high body temperature (hyperthermia), control muscle spasms with diazepam and phenobarbital, remove the patient/victim’s clothing, and encourage evaporative heat loss with fans and water to the skin.
• Seek medical attention immediately.

• Immediately remove the patient/victim from the source of exposure.
• Evaluate respiratory function and pulse.
• Ensure that the patient/victim has an unobstructed airway.
• If shortness of breath occurs or breathing is difficult (dyspnea), administer oxygen.
• Assist ventilation as required. Always use a barrier or bag-valve-mask device.
• If breathing has ceased (apnea), provide artificial respiration.
• See the Ingestion section for first aid recommendations.
• Also see Ingestion Exposure.
• Seek medical attention immediately.

• Immediately remove the patient/victim from the source of exposure.
• See the Decontamination section for patient/victim decontamination procedures.
• Seek medical attention immediately.

If the patient/victim can be rapidly transported to an emergency department following decontamination, stomach pumping (gastric lavage) may be considered after the airway has been secured and neuromuscular hyperactivity is controlled. Gastric lavage is recommended only after ingestion of a life-threatening amount of the agent and only if it can be done shortly after ingestion (generally within 1 hour). Muscle spasms resistant (refractory) to diazepam and phenobarbital plus respiratory failure may require treatment with paralyzing agents, intubation, and mechanical ventilation. Fluid and electrolyte balance should be monitored and restored if abnormal. Measures to prevent and correct accumulation of acid in blood and tissues (metabolic acidosis) should be implemented. Arterial blood gases should be monitored in all symptomatic patient/victims. Dialysis may be necessary in patient/victims with kidney failure.

Not established/determined

Information is unavailable about the carcinogenicity, developmental toxicity, or reproductive toxicity from chronic or repeated exposure to strychnine.

• Consult with the Incident Commander regarding the agent dispersed, dissemination method, level of PPE required, location, geographic complications (if any), and the approximate number of remains.
• Coordinate responsibilities and prepare to enter the scene as part of the evaluation team along with the FBI HazMat Technician, local law enforcement evidence technician, and other relevant personnel.
• Begin tracking remains using waterproof tags.

• Wear PPE until all remains are deemed free of contamination.
• Establish a preliminary (holding) morgue.
• Gather evidence, and place it in a clearly labeled impervious container. Hand any evidence over to the FBI.
• Remove and tag personal effects.
• Perform a thorough external evaluation and a preliminary identification check.
• See the Decontamination section for decontamination procedures.
• Decontaminate remains before they are removed from the incident site.

The following methods can be used to decontaminate the environment/spillage disposal:

• Do not touch or walk through the spilled agent if at all possible. However, if you must, personnel should wear the appropriate PPE during environmental decontamination. See the PPE section of this card for detailed information.
• Keep combustibles (e.g., wood, paper, and oil) away from the spilled agent. Use water spray to reduce vapors or divert vapor cloud drift. Avoid allowing water runoff to contact the spilled agent.
• Do not direct water at the spill or the source of the leak.
• Stop the leak if it is possible to do so without risk to personnel, and turn leaking containers so that gas rather than liquid escapes.
• Prevent entry into waterways, sewers, basements, or confined areas.
• Isolate the area until gas has dispersed.
• Ventilate the area.

Agents can seep into the crevices of equipment making it dangerous to handle. The following methods can be used to decontaminate equipment:

• Not established/determined