Cyanide toxicity
From IDWiki
Pathophysiology
- Blocks the electron transport chain (ETC) complex 4, resulting in increased anaerobic metabolism
Clinical Manifestations
- Inhalation exposure with high lactate and venous hyperoxia
- Headache
- Nausea/vomiting
- Tachycardia
- Confusion
- Seizures
- Flushing more than cyanosis
Investigations
- Laboratory
- Lactate will be high
Management
- Resuscitation
- Decontamination
- Hydroxycobalamin 5g IV x1, repeated if severe
- Sodium thiosulfate 12.5g IV x1
- Last-line: sodium nitrite
- Co-exposures
