Prehospital recognition and treatment of acute cyanide poisoning
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 9
Abstract
Cyanide poisoning is characterized by a considerable mortality, reaching up to 95%. These poisonings occur more often than medical statistics show that as the largest group of patients are victims of fires. Properly carried out decontamination, early use of antidotes and adequate intensive symptomatic treatment can greatly improve the prognosis in these poisonings.Based on data from literature and own experience are discussed in paper: source of cyanide ions, the mechanism of their toxicity, in which situations intoxication should be suspected and the signs of cyanide poisoning.In severe cyanide poisoning death can occur within minutes, and specific antidote therapy should be implemented as soon as possible – preferably on the spot intoxication or during transport to the hospital emergency department. For the safest, effective cyanide antidote binding ions hydroxocobalamin is considered. Hydroxocobalamin can be used in all of cyanide poisoning, regardless of the route of intoxication, and the source (including the victims of fires) and empirically in patients in whom there is a strong suspicion of such poisoning. Given the positive experience of the French with prehospital administration of hydroxocobalamin, a positive assessment of the FDA, as well as the significant momentum and a high mortality rate of cyanide poisoning, the authors believe to be reasonable to allow the medical use of rescuers prehospital hydroxocobalamin use as the treatment of severe cyanide poisoning. This decision may be particularly advantageous in the case of mass poisoning, especially following the terrorist acts.
Authors and Affiliations
Magdalena Łukasik-Głębocka, Krystyn Sosada, Jerzy Ładny, Marzena Wojewódzka-Żelezniakowicz, Sławomir Czaban
Keywords
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