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



Episoder(1145)

Podcast #262: Pertussis

Podcast #262: Pertussis

Author: Julian Orenstein, M.D. Educational Pearls Colorado has a high population of unvaccinated children, and is at increased risk for pertussis outbreaks. The causative organism is Bordetella pertu...

23 Okt 20174min

Deep Dive #7: Domestic Violence

Deep Dive #7: Domestic Violence

Authors: Katie Sprinkel, MD Emergency Medicine Physician SANE Medical Director, Medical Center of Aurora Amy Ferrin, Senior Deputy District Attorney County Court Supervisor Office of the District A...

16 Okt 201737min

Podcast #261: Icatibant

Podcast #261: Icatibant

Author: Aaron Lessen, M.D. Educational Pearls Icatibant was introduced to treat ACE-inhibitor induced angioendema. This type of angioedema is refractory to epinephrine and antihistamines, and is like...

13 Okt 20172min

Podcast #260: Preoxygenation

Podcast #260: Preoxygenation

Author: David Rosenberg, M.D. Educational Pearls Preoxygenation is done before rapid sequence intubation, and should be done even if SaO2 is at 100%. Preoxygenation is done to fill the lungs with oxy...

11 Okt 20172min

Podcast #259: Transient Ischemic Attacks

Podcast #259: Transient Ischemic Attacks

Podcast #259: TIA Author: Peter Bakes, M.D. Educational Pearls A TIA is defined as focal neurological deficit that resolves within 24 hours and has negative imaging. The etiology is a transient throm...

9 Okt 20177min

Podcast #258: REBOA

Podcast #258: REBOA

Author: Dylan Luyten, M.D. Educational Pearls Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Exsanguination is a major cause of mortality in trauma One temporizing technique to bu...

6 Okt 20173min

Podcast #257: Strangulation

Podcast #257: Strangulation

Educational Pearls Strangulation is common in cases of domestic violence and sexual assault, and it is associated with higher mortality People who have been strangled have a higher rate of stroke due...

4 Okt 20174min

Podcast #256: Fentanyl Ingestion

Podcast #256: Fentanyl Ingestion

Authors: Don Stader, M.D & Rachael Duncan, PharmD BCPS BCCCP Educational Pearls Fentanyl patches may be abused in many ways, including changing the patches more frequently, chewing them, extracting t...

2 Okt 20175min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
rss-nysgjerrige-norge
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie
smart-forklart
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
abels-tarn
tomprat-med-gunnar-tjomlid
aldring-og-helse-podden