Sodium thiosulfate antidote5/8/2023 With acute toxicity there is no reliable pathognomonic toxidrome or characteristic symptoms.Toxicity is mainly due to cyanide’s inhibition of cytochrome oxidase in the electron transport chain which halts ATP production leading to acidosis and anaerobic metabolism despite an often oxygen rich environment.Cyanogenic glycosides found in fruits with pits containing amygdalin (apricots, cherries, peaches) or improperly prepared cassava.Exposure to cyanide can happen in a variety of settings such as with smoke inhalation, laboratory/industrial accidents, suicide or homicide attempts, and accidental ingestion. ![]() What are the available treatments for cyanide toxicity, and how do I know which one(s) to use? Background:Ĭyanide is a very potent toxin that can cause life-threatening symptoms in small doses. ![]() Initial labs reveal a lactate of 12 mmol/L. ![]() The patient is now awake and crying and is noted to have significant amount of soot covering his entire body. ![]() EMS states that firefighters on scene believe the fire started when a cigarette fell on a sofa covered in plastic. Authors: Elise Alves Graber, MD (Pediatric Emergency Medicine Fellow, Atrium Health’s Carolinas Medical Center), Christine Murphy, MD (Emergency Medicine Attending, Medical Toxicologist, Atrium Health’s Carolinas Medical Center) // Reviewed by: Cynthia Santos, MD Santos, MD) Alex Koyfman, MD and Brit Long, MD presentation:Ī 3-year-old male is brought into the emergency department by EMS after being found unconscious in a house fire.
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