Case Files of the University of Massachusetts Toxicology Fellowship: Does This Smoke Inhalation Victim Require Treatment with Cyanide Antidote?

J Med Toxicol. 2016 Jun;12(2):192-8. doi: 10.1007/s13181-016-0533-0.

Abstract

Cyanide toxicity is common after significant smoke inhalation. Two cases are presented that provide framework for the discussion of epidemiology, pathogenesis, presenting signs and symptoms, and treatment options of inhalational cyanide poisoning. An evidence-based algorithm is proposed that utilizes point-of-care testing to help physicians identify patients who benefit most from antidotal therapy.

Keywords: Cyanide; Fire; Hydroxocobalamin; Smoke inhalation; Sodium thiosulfate.

Publication types

  • Review

MeSH terms

  • Academic Medical Centers
  • Algorithms
  • Antidotes / adverse effects
  • Antidotes / therapeutic use*
  • Biomarkers / blood
  • Combined Modality Therapy / adverse effects
  • Decision Trees
  • Evidence-Based Emergency Medicine*
  • Fellowships and Scholarships
  • Female
  • Gas Poisoning / complications
  • Gas Poisoning / diagnosis
  • Gas Poisoning / drug therapy*
  • Gas Poisoning / therapy
  • Humans
  • Hydrogen Cyanide / antagonists & inhibitors
  • Hydrogen Cyanide / toxicity*
  • Hydroxocobalamin / adverse effects
  • Hydroxocobalamin / therapeutic use
  • Male
  • Massachusetts
  • Point-of-Care Testing
  • Smoke Inhalation Injury / blood
  • Smoke Inhalation Injury / complications*
  • Smoke Inhalation Injury / therapy
  • Toxicology / education
  • Workforce

Substances

  • Antidotes
  • Biomarkers
  • Hydrogen Cyanide
  • Hydroxocobalamin