Cyanide Poisoning

“ Cyanide Poisoning: An Old Enemy with New Risks” By Mary Jo Koschel, MSN,CFRN, NREMT-P PVH EMS Paramedic Clinical Coordinator North Colorado Med Evac, Flight Nurse

A notorious poison used repeatedly throughout the centuries…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cyanide and Fire Smoke ,[object Object],[object Object]

Case in point….. ,[object Object],[object Object]

Mechanism of Cyanide Poisoning ,[object Object],[object Object]

Routes of exposure…. ,[object Object],[object Object],[object Object]

Symptoms of Acute Cyanide Poisoning ,[object Object],[object Object]

So why aren’t we tripping over all the dead bodies from cyanide poisoning???

Factors effecting symptomolgy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Early symptoms ,[object Object],[object Object],[object Object],[object Object]

Severe cyanide poisoning is manifested by hypotension, seizures, coma, respiratory depression, cardiovascular collapse and cardio respiratory arrest……not very specific……so when do we treat for cyanide poisoning?

Presumptive diagnosis…. ,[object Object],[object Object],[object Object],[object Object]

Remove from exposure… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cyanide Antidote Kit- ,[object Object],[object Object],[object Object],CH3>CHCH2CH2ONO CH3 Amyl nitrite

Cyanide Antidote Kit not generally recommended in smoke-inhalation victims… ,[object Object],[object Object],[object Object]

Introducing Hydroxocobalamin This is the future of Cyanide Exposure Treatment

Properties of Hydroxocobalamin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical course post-poisoning… ,[object Object],[object Object],[object Object],[object Object]

Monthly Points To Ponder (MPTP)… ,[object Object],[object Object],[object Object],[object Object]

Scenario… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Scenario continued… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Cyanide Poisoning

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Cyanide Poisoning