1254. Airway casts treatment // Assessment and management of possible CO intoxication with inhalation injury // When to consider cyanide intoxication // What parameter to follow in burned patient requiring fluid resus who has cardiopulmonary disease // What % TBSA correlates with need for fluid resus // Acceptable UOP // Hydroxycobolamine B12 dose in Cyanide Toxicity

September 26th, 2009
by reuben in .burn

Emcard2508

Back Top

Responses to “1254. Airway casts treatment // Assessment and management of possible CO intoxication with inhalation injury // When to consider cyanide intoxication // What parameter to follow in burned patient requiring fluid resus who has cardiopulmonary disease // What % TBSA correlates with need for fluid resus // Acceptable UOP // Hydroxycobolamine B12 dose in Cyanide Toxicity”

  1. When to suspect CN on top of CO poisoning:

    Fire victims covered in soot with triad of (1) hypotension, (2) metabolic acidosis (with anion-gap) and (3) elevated lactate level (>8-10) -> such patients should be treated empirically for CO and CN toxicity: hydroxycobolamine is the agent of choice, and nitrates should be avoided (the sodium thiosulfate agent also present in the CN-kit may be used as well)

    Other situations: fumigators, photographers, jewelers, nail polish use, apricot pits ingestion or iatrogenic nitroprusside overdose

    Use: Hydroxycobolamine 5g IV (needs to be diluted) over 15min (both 2.5g vials of the ?Hydroxycobolamine kit? need to be given), repeated up to 15g total if necessary Pediatric dose is 70mg/kg per infusion

    Side-effects: chromoturia (red discoloration of urine, and possibly of blood drawn), possible hypertension (due to NO scavenging properties ? do not treat the hypertension with nitrates)

Leave a Reply