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



Avsnitt(1145)

Podcast #248: Family Presence During Resuscitation

Podcast #248: Family Presence During Resuscitation

Author: Aaron Lessen, M.D. Educational Pearls Traditionally the family is removed from the room during procedures and codes, but recent research shows that family presence may be beneficial. 50% pati...

8 Sep 20173min

Podcast #249: D-Dimer

Podcast #249: D-Dimer

Author: Michael Hunt, M.D. Educational Pearls In the recent YEARS study, investigators checked every patient with suspicion for PE with a D-dimer, using a modified Wells score for risk stratification...

6 Sep 20173min

Podcast #248: Patent Foramen Ovale

Podcast #248: Patent Foramen Ovale

Author: Jared Scott, M.D. Educational Pearls The foramen ovale (FO) connects the left and right atria to allow oxygenated blood to bypass the developing lungs, it usually closes at birth but for some...

4 Sep 20173min

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Podcast #247: Are You Listening? - 3 Ear Emergencies You Can't Miss!

Author: Don Stader, M.D. Educational Pearls Ear pain is a common complaint in adults and kids. A red, hot, painful ear with involvement of the pinna could indicate perichondritis - an infection of th...

2 Sep 20176min

Podcast #246: Fever in Sepsis

Podcast #246: Fever in Sepsis

Author: Nick Hatch, M.D. Educational Pearls A recent observational cohort study found that the biggest predictor for sepsis survival was fever. Those with higher fevers had better outcomes. Some poss...

31 Aug 20172min

Podcast #245: Hypoglycemia

Podcast #245: Hypoglycemia

Author: Dylan Luyten, M.D. Educational Pearls Hypoglycemia is very common in type 2 diabetics, and is often caused by insulin overdose or missed meals. Knowing the peak time of action for common diab...

29 Aug 20174min

Podcast #244: Clavicle Fracture Review

Podcast #244: Clavicle Fracture Review

Author: Nick Hatch, M.D. Educational Pearls The force required to break a clavicle is significant, so clavicle fracture may be associated with other injury (pneumothorax, vascular injury). Most fract...

27 Aug 20172min

Podcast #243: Sphenopalatine Nerve Block

Podcast #243: Sphenopalatine Nerve Block

Author: Don Stader, M.D. Educational Pearls Cluster headaches are usually intense, unilateral, and involve the periorbital area. CN V (Trigeminal) provides sensory and autonomic innervation the face...

25 Aug 20174min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion
rss-vetenskapsradion-2
sexet
halsorevolutionen
rss-ufo-bortom-rimligt-tvivel
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
rss-spraket
medicinvetarna
bildningspodden
vetenskapsradion
rss-lara-fran-larda-en-fackbok-och-en-forfattare