STUDY OBJECTIVE To assess outcomes in patients treated with hydroxocobalamin at the fire scene or in the ICU for suspected smoke inhalation-associated cyanide poisoning. METHODS Adult smoke inhalation victims with suspected cyanide poisoning as determined by soot in the face, mouth, or nose or expectorations and neurologic impairment received an intravenous infusion of hydroxocobalamin 5 g (m...

Although the efficacy of induced methemoglobinemia in cyanide poisoning has been demonstrated both therapeutically and prophylactically (l),l the tissue reactions involved in the protection of animals from the lethal effects of the cyanide ion by methemoglobin are only imperfectly understood. Presumably, cyanide interferes with cellular respiration by forming a slightly dissociable complex with...

This paper reviews the current literature on smoke inhalation injuries with special attention to the effects of hydrogen cyanide. It is assumed that cyanide poisoning is still an overlooked diagnosis in fire victims. Treatment against cyanide poisoning in the emergency setting should be given based on the clinical diagnosis only. Oxygen in combination with a recommended antidote should be given...

STUDY OBJECTIVE Exposure to cyanide in fires and industrial exposures and intentional cyanide poisoning by terrorists leading to mass casualties is an ongoing threat. Current treatments for cyanide poisoning must be administered intravenously, and no rapid treatment methods are available for mass casualty cyanide exposures. Cobinamide is a cobalamin (vitamin B(12)) analog with an extraordinaril...

Cyanide poisoning must be seriously considered in victims of smoke inhalation from enclosed space fires; it is also a credible terrorism threat agent. The treatment of cyanide poisoning is empiric because laboratory confirmation can take hours or days. Empiric treatment requires a safe and effective antidote that can be rapidly administered by either out-of-hospital or emergency department pers...

Plants Containing Cyanogenic Glycosides Cyanogenic glycosides are substances present in many plants that can produce highly toxic hydrogen cyanide (HCN) or prussic acid. Specific plant enzymes released when plant cells are damaged when chewed, crushed, wilted, or frozen, hydrolyze the glycosides to cyanide. At least 2000 plant species are known to contain cyanogenic glycosides with the potentia...