Diagnosis should be suspected in an acyanotic patient with severe hypoxia. As differential diagnosis, carbon monoxide poisoning, exposure to organic solvents, drug intoxication, hypoglycemia, electrolyte disturbances, and postictal state should be considered. Cyanogen chloride induces mucosal irritation and excessive respiratory secretions, which are reminiscent of organophosphate poisoning. Laboratory findings are lactic acidosis and a decrease in the arterial-venous difference in partial pressure of oxygen [120] . Plasma thiocyanate levels can be measured, but not acutely.