Podcast 574:  Cyanide Toxicity

Podcast 574: Cyanide Toxicity

Contributor: Nick Tsipis, MD

Educational Pearls:

  • Significant cyanide exposure most commonly occurs from fire/smoke exposure particularly when plastics are involved
  • Cyanide binds to cytochrome oxidase leading to the use of anaerobic metabolism which causes a profound lactic acidosis
  • Classic toxicity includes a rapid loss of consciousness, hypotension, bradycardia, respiratory depression, and seizures
  • Mild exposures can lead to nausea/vomiting, headaches, and other nonspecific symptoms.
  • Sometimes patients will complain of an almond taste.
  • Cyanide toxicity will manifest on labs by a profound anion gap acidosis with elevated lactate (but don't wait for them to ponder the diagnosis)
  • Antidote is hydroxocobalamin and sodium thiosulfate
  • Severe cyanide exposure will likely need ICU level care until the blood gas levels return to their baselines and the lactic acidosis resolves

References

Nickson Chris C, Australian Centre for Health Innovation at Alfred Health. Cyanide Poisoning • LITFL • CCC Toxicology. Life in the Fast Lane • LITFL • Medical Blog. https://litfl.com/cyanide-poisoning-ccc/. Published April 2, 2019. Accessed June 11, 2020.

Parker-Cote JL, Rizer J, Vakkalanka JP, Rege SV, Holstege CP. Challenges in the diagnosis of acute cyanide poisoning. Clin Toxicol (Phila). 2018;56(7):609‐617. doi:10.1080/15563650.2018.1435886

MacLennan L, Moiemen N. Management of cyanide toxicity in patients with burns. Burns. 2015;41(1):18‐24. doi:10.1016/j.burns.2014.06.001

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD



Jaksot(1145)

Podcast 849: Large Vessel Occlusions

Podcast 849: Large Vessel Occlusions

Contributor: Travis Barlock MD Educational Pearls:  Large Vessel Occlusion (LVO) is a condition where a clot blocks one of the major blood vessels in the brain, leading to a stroke. What are the vesse...

1 Touko 20233min

Podcast 848: Non-Traditional RSI

Podcast 848: Non-Traditional RSI

Contributor: Meghan Hurley, MD Educational Pearls: Two main reasons to choose non-traditional RSI Anatomically challenging airway Physiologically difficult patients: hypoxia, metabolic acidosi...

24 Huhti 20235min

Podcast 847: ECMO CPR

Podcast 847: ECMO CPR

Contributor: Aaron Lessen, MD Educational Pearls: Extracorporeal Membrane Oxygenation (ECMO) has been attempted as an adjunct to CPR during cardiac arrest but few studies on outcomes exist One prior...

6 Helmi 20233min

Podcast 846: Early Repolarization vs. Anterior STEMI

Podcast 846: Early Repolarization vs. Anterior STEMI

Contributor: Travis Barlock, MD Educational Pearls: Early repolarization a benign EKG pattern that can mimic an anterior STEMI Can be seen in the anterior leads typically in young male patients Can d...

30 Tammi 20232min

Podcast 845: Hyperkalemic Cardiac Arrest

Podcast 845: Hyperkalemic Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Hyperkalemia may cause cardiac arrest Treatment of suspected hyperkalemic cardiac arrest begins with typical management of cardiac arrest including ...

16 Tammi 20234min

Podcast 844: Dental Infections

Podcast 844: Dental Infections

Contributor: Meghan Hurley, MD Educational Pearls: Educational Pearls: Dental infections can be categorized into two main groups Infections of the gums Pericoronitis Tooth eruption leading to infl...

10 Tammi 20234min

Podcast 843: Commotio Cordis

Podcast 843: Commotio Cordis

Contributor: Jared Scott, MD Educational Pearls: Commotio cordis is sudden ventricular fibrillation precipitated by direct impact to the chest A national registry, US Commotio Cordis Registry, repor...

9 Tammi 20234min

Podcast 842: "History of Wound Care"

Podcast 842: "History of Wound Care"

Contributor: Chris Holmes, MD Educational Pearls: Through world history, there have been various interesting approaches to wound care Ancient Egyptians applied honey, lint, and grease which provided ...

4 Tammi 20234min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
rss-duodecim-lehti
rss-sosiopodi
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
utelias-mieli
mielipaivakirja
rss-bios-podcast
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita