Burns injury - PACT - ESICM

Purple urine after
hydroxycobalamin
Emergency treatment includes 100% O 2 , tracheal intubation in case of
unconsciousness, symptomatic treatment of seizures and hypotension, and
administration of an antidote as soon as available. A commonly used antidote is
hydroxocobalamin (Cyanokit).
Cyanide may contaminate the rescuers!
In the case of chemical disasters, caregivers should wear chemical-protective clothes
with positive-pressure breathing apparatus when they are at risk of being
contaminated. Any contact with salts or solutions containing cyanide or inhaling
hydrogen cyanide gas from vomitus must be avoided. Contaminated clothes should be
removed and bagged.
Lawson-Smith P, Jansen EC, Hyldegaard O. Cyanide intoxication as part of
smoke inhalation--a review on diagnosis and treatment from the
emergency perspective. Scand J Trauma Resusc Emerg Med 2011; 19: 14.
PMID 21371322
Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, Vicaut E, et al. Value
of lactic acidosis in the assessment of the severity of acute cyanide
poisoning. Crit Care Med 2002; 30(9): 2044–2250. PMID 12352039
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