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(1147)

Podcast 658: Febrile Seizures

Podcast 658: Febrile Seizures

Contributor: Peter Bakes, MD Educational Pearls: Febrile Seizure clinical criteria 6 months - 5 years of age Rapid rise in temp No preexisting seizure disorder No other explanation for the seizure...

13 Apr 20214min

Podcast 657: Caustic Ingestion

Podcast 657: Caustic Ingestion

Contributor: Aaron Lessen, MD Educational Pearls: Acid and alkali ingestions have differing prognosis and immediate concerns Immediate issues can include superficial irritation, severe burns, esopha...

12 Apr 20213min

Podcast 656: Rashes

Podcast 656: Rashes

Contributor:  Peter Bakes, MD Educational Pearls: Lyme disease gives a single expanding target lesion with central clearing called erythema chronicum migrans Erythema multiforme is another targetoid ...

7 Apr 20217min

Podcast 655: Hypothermia in Sepsis

Podcast 655: Hypothermia in Sepsis

Contributor: Adam Barkin, MD Educational Pearls: Fever is an adaptive response to infection, but elderly and immunocompromised patients may not be able to mount a hyperthermic response in sepsis Pati...

6 Apr 20213min

Podcast 654: Depression in COVID

Podcast 654: Depression in COVID

Contributor: Aaron Lessen, MD Educational Pearls: Survey study compared depression symptom prevalence in the United States at the beginning of COVID compared to data acquired by a similar survey for...

5 Apr 20213min

Podcast 653: Nitroglycerin Disimpaction

Podcast 653: Nitroglycerin Disimpaction

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Glucagon administered intravenously has a high rate of adverse events (nausea/vomiting) with very weak evidence NItroglycerin too has very lim...

30 Mars 20212min

Podcast 652: Prosthetic Hip Dislocation

Podcast 652: Prosthetic Hip Dislocation

Contributor: Jared Scott, MD Educational Pearls: While it is rare to have a native hip dislocation, it is relatively common to dislocate a prosthetic hip The mechanism for dislocation is usually add...

29 Mars 20215min

Dr. Don Stader Shares Personal Experience of Losing his Mother to COVID-19 and Ruminates on the Culture of Death in Medicine (UnfilterED #12 Excerpt)

Dr. Don Stader Shares Personal Experience of Losing his Mother to COVID-19 and Ruminates on the Culture of Death in Medicine (UnfilterED #12 Excerpt)

A heartfelt excerpt from our most recent UnfilterED episode with Dr. Don Stader.

26 Mars 202120min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
medicinvetarna
rss-ufo-bortom-rimligt-tvivel
kapitalet-en-podd-om-ekonomi
rss-experimentet
rss-vetenskapsradion-2
sexet
rss-vetenskapsradion
hacka-livet
det-morka-psyket
dumforklarat
rss-spraket
pojkmottagningen
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
4health-med-anna-sparre
halsorevolutionen
rss-personlighetspodden