Cyanide toxicity

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Revision as of 20:53, 21 July 2020 by Aidan (talk | contribs) (Text replacement - "Clinical Presentation" to "Clinical Manifestations")
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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
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