Citation

Anseeuw K, Delvau N, Burillo-Putze G, De Iaco F, Geldner G, Holmström P, Lambert Y, Sabbe M. Eur. J. Emerg. Med. 2013; 20(1): 2-9.

Affiliation

aDepartment of Emergency Medicine, ZNA Stuivenberg, Antwerp bDepartment of Emergency Medicine, Cliniques Universitaires Saint-Luc, Brussels cDepartment of Emergency Medicine, University Hospital Gasthuisberg, Leuven, Belgium dDepartment of Emergency Medicine, Hospital Universitario de Canarias, Tenerife, Spain eDepartment of Emergency Medicine, A.S.L. 1 'Imperiese', Imperia, Italy fKlinikum Ludwigsburg, Ruprecht Karls University, Heidelberg, Germany gHelsinki EMS, Helsinki University Hospital, Helsinki, Finland hDepartment of Emergency Medicine, Versailles Hospital, Le Chesnay, France.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/MEJ.0b013e328357170b

PMID

22828651

Abstract

Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. The diagnosis of cyanide poisoning remains very difficult, and failure to recognize it may result in inadequate or inappropriate treatment. Findings suggesting cyanide toxicity include the following: (a) a history of enclosed-space fire; (b) any alteration in the level of consciousness; (c) any cardiovascular changes (particularly inexplicable hypotension); and (d) elevated plasma lactate. The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims.

Language: en