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(1147)

Podcast 560:  Imaging in a COVID world

Podcast 560: Imaging in a COVID world

Contributor: Don Stader, MD Educational Pearls: COVID-19 commonly appears as a bilateral patchy infiltrate on chest radiograph, but this is a non-specific finding Sensitivities range from 17-70% f...

7 Touko 20206min

Mental Health Monthly #3: Maintaining Mental Health and Wellness for Healthcare Professionals

Mental Health Monthly #3: Maintaining Mental Health and Wellness for Healthcare Professionals

In this timely installment of Mental Health Monthly, mental health expert Lexi Eliades shares useful tips for identifying burnout and mental health decline as well as ways to maintain mental wellness ...

6 Touko 202010min

Podcast 559: Metabolic Acidosis

Podcast 559: Metabolic Acidosis

Contributor: Dylan Luyten, MD Educational Pearls Acidosis can be caused by a respiratory, metabolic, or mixed source A respiratory acidosis will have a low serum pH and elevated bicarbonate if it's c...

5 Touko 20203min

Podcast 558:  Rapid ARDS Review

Podcast 558: Rapid ARDS Review

Contributor: Don Stader, MD Educational Pearls: Acute respiratory distress syndrome (ARDS) is a catch all term for when lung injury leads to fluid collection in the air spaces of the lungs  Ventila...

4 Touko 20204min

COVID-19 Digest: Strokes in Young People with COVID

COVID-19 Digest: Strokes in Young People with COVID

Last week we looked at neurologic presentations of COVID-19; this week we'll look more closely at strokes in young people with COVID. A letter published 2 days ago in the NEJM with lead author Thomas ...

1 Touko 20208min

Podcast 557:  COVID-19 Lab Trends

Podcast 557: COVID-19 Lab Trends

Contributor: Don Stader, MD Educational Pearls: COVID-19 is diagnosed with a nasopharyngeal swab (q-tip). This unfortunately can be painful, but if the swab doesn't go deep into the nasal cavity th...

29 Huhti 20207min

Podcast 556:  CSF - What is it good for?

Podcast 556: CSF - What is it good for?

Contributor: Eric Miller, MD Educational Pearls: A cell count is performed on tubes 1 and 4 to account for changes that may occur from blood entering the first sample from the needle insertion Tube 2...

28 Huhti 20206min

Podcast 555:  Anticoagulation vs. Antiplatelet

Podcast 555: Anticoagulation vs. Antiplatelet

Contributor: Don Stader, MD Educational Pearls: When do we give antiplatelet drugs or anti-coagulation drugs? Arterial issues get antiplatelet therapy Venous issues, or slow flow states, get antico...

27 Huhti 20203min

Suosittua kategoriassa Tiede

rss-poliisin-mieli
rss-mita-tulisi-tietaa
tiedekulma-podcast
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
radio-antro
utelias-mieli
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi