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(1146)

Podcast # 489: Bats & Rabies

Podcast # 489: Bats & Rabies

Contributor: Jared Scott, MD Educational Pearls: The CDC recommends rabies prophylaxis if there was a direct encounter with a possibly rabid animal except... Bats are treated differently since their ...

18 Heinä 20193min

Podcast # 488: Dalbavancin

Podcast # 488: Dalbavancin

Contributor: Nick Hatch, MD Educational Pearls: Dalbavancin (Dalvance®) is an antibiotic that can be used for skin and soft tissue infections, providing MRSA coverage It cannot be used in other infec...

15 Heinä 20193min

Podcast # 487: Hunting for Epiglottitis

Podcast # 487: Hunting for Epiglottitis

Contributor: Michael Hunt, MD Educational Pearls: Due to the efficacy of vaccination, epiglottitis is now more common in adults than children Risk factors include smoking and other immunocompromising...

10 Heinä 20193min

Podcast # 486: Morel Mushrooms

Podcast # 486: Morel Mushrooms

Contributor: Nick Hatch, MD Educational Pearls: True morel mushrooms are commonly foraged The false morel mushroom (Gyromitra esculenta) looks similar to the true morel, but is toxic False morel mush...

8 Heinä 20194min

Podcast # 485: Cerebellar Stroke

Podcast # 485: Cerebellar Stroke

Contributor: Jared Scott, MD Educational Pearls: Cerebellar strokes make up a disproportionate number of missed or delayed diagnosis for stroke likely due to the subtle nature of the presentation Cer...

6 Heinä 20195min

Podcast # 484: Elevated ICP

Podcast # 484: Elevated ICP

Contributor: Charleen Gnisci, PharmD Educational Pearls: Causes of increased intracranial pressure may include intracranial hemorrhage, malignancy, and trauma. While definite treatment is to remove ...

4 Heinä 20196min

Podcast # 483: Dual Antiplatelet Therapy in TIA

Podcast # 483: Dual Antiplatelet Therapy in TIA

Contributor: Don Stader, MD Educational Pearls: Antiplatelets include aspirin and clopidogrel, and are generally used for arterial clotting (MI, stroke) Anticoagulants such as coumadin, Xarelto, Eliq...

28 Kesä 20192min

Podcast # 482: Tetracyclines and Hyperpigmentation

Podcast # 482: Tetracyclines and Hyperpigmentation

Contributor: Michael Hunt, MD Educational Pearls: Tetracycline antibiotics such as minocycline can cause greyish hyperpigmentation This hyperpigmentation can sometimes be reversible but not always Mi...

26 Kesä 20193min

Suosittua kategoriassa Tiede

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