scholarly journals A case of cyanide poisoning complicated with carbon monoxide poisoning caused by smoke inhalation

2014 ◽  
Vol 25 (10) ◽  
pp. 797-803
Author(s):  
Yasumasa Iwasaki ◽  
Akira Narame ◽  
Kazunobu Une ◽  
Kohei Ota ◽  
Yoshiko Kida ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Smoke Inhalation ◽  
Cyanide Poisoning

scholarly journals Smoke inhalation injury during enclosed-space fires: an update

2013 ◽  
Vol 39 (3) ◽  
pp. 373-381 ◽  
Author(s):  
Ana Carolina Pecanha Antonio ◽  
Priscylla Souza Castro ◽  
Luiz Octavio Freire
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Fiberoptic Bronchoscopy ◽  
Orotracheal Intubation ◽  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Cyanide Poisoning ◽  
Smoke Inhalation Injury ◽  
Acute Airway Obstruction ◽  
Enclosed Space

In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection

scholarly journals Is There An Ideal Prehospital Drug Treatment For Acute Cyanide Poisoning?

2015 ◽  
Vol 12 (3) ◽  
Author(s):  
Craig B Barraclough
Keyword(s):  
Carbon Monoxide ◽  
Drug Treatment ◽  
Sodium Nitrite ◽  
Keyword Search ◽  
Haemodynamic Effects ◽  
Smoke Inhalation ◽  
Cyanide Poisoning ◽  
Sodium Thiosulphate ◽  
Negative Effects ◽  
Amyl Nitrite

IntroductionCyanide, due to its toxicity and prevalence in a variety of industries, is a suitable agent for terrorists or disaffected persons to use as a weapon of terror. New Zealand’s National Poisons Centre lists five cyanide antidotes. This review aimed to identify whether there is an ideal pre-hospital drug treatment for acute cyanide poisoning.MethodsLiterature less than 10 years old was selected after a keyword search. The articles were reviewed for specific positive and negative properties of each antidote.ResultsThirty-nine articles were reviewed of which four were excluded. Results varied, with hydroxocobalamin scoring highly on effectiveness, with limited negative effects. It also demonstrated positive haemodynamic effects, suitability in cases involving trauma, carbon monoxide (CO), smoke inhalation casualties and was safe for pre-hospital use. Sodium nitrite, followed by dicobalt edetate had the next highest scores for efficacy. However, both scored negatively for their effects on blood, causing hypotension and toxicity, and they are unsuitable for trauma, CO or smoke inhalation casualties. Sodium thiosulphate, with a moderate level of efficiency, remained most effective when co-administered with other antidotes. 4-dimethylaminophenol and amyl nitrite rated the lowest, with negative effects similar to sodium nitrite. Adrenaline was tested as an antidote in one study where two novel antidotes both demonstrated promising results.ConclusionHydroxocobalamin had the highest success rate and its safety profile make it the most suitable pre-hospital drug treatment for acute cyanide poisoning.

Carbon monoxide poisoning can act as a stress test to reveal underlying coronary artery disease: case report

2020 ◽  
pp. 151-169
Author(s):  
Lindell K. Weaver ◽  
◽  
Keyword(s):  
Carbon Monoxide ◽  
Hyperbaric Oxygen ◽  
Carbon Monoxide Poisoning ◽  
Stress Test ◽  
The United States ◽  
Brain Inflammation ◽  
Smoke Inhalation ◽  
Co Poisoning ◽  
Exposure Limits ◽  
Disease Case

Despite established exposure limits and safety standards as well as the availability of carbon monoxide (CO) alarms, each year 50,000 people in the United States visit emergency departments for CO poisoning. Carbon monoxide poisoning can occur from brief exposures to high levels of CO or from longer exposures to lower levels. Common symptoms can include headaches, nausea and vomiting, dizziness, general malaise, and altered mental status. Some patients may have chest pain, shortness of breath, and myocardial ischemia, and may require mechanical ventilation and treatment of shock. Individuals poisoned by CO often develop brain injury manifested by neurological problems, including cognitive sequelae, anxiety and depression, persistent headaches, dizziness, sleep problems, motor weakness, vestibular and balance problems, gaze abnormalities, peripheral neuropathies, hearing loss, tinnitus, Parkinsonian-like syndrome, and other problems. In addition, some will have cardiac issues or other ailments. While breathing oxygen hastens the removal of carboxyhemoglobin (COHb), hyperbaric oxygen (HBO2) hastens COHb elimination and favorably modulates inflammatory processes instigated by CO poisoning, an effect not observed with breathing normobaric oxygen. Hyperbaric oxygen improves mitochondrial function, inhibits lipid peroxidation transiently, impairs leukocyte adhesion to injured microvasculature, and reduces brain inflammation caused by the CO-induced adduct formation of myelin basic protein. Based upon three supportive randomized clinical trials in humans and considerable evidence from animal studies, HBO2 should be considered for all cases of acute symptomatic CO poisoning. Hyperbaric oxygen is indicated for CO poisoning complicated by cyanide poisoning, often concomitantly with smoke inhalation.

Diabetes Insipidus after Carbon Monoxide Poisoning and Smoke Inhalation

1985 ◽  
Vol 25 (7) ◽  
pp. 662-663 ◽  
Author(s):  
PAUL HALEBIAN ◽  
ROGER YURT ◽  
CAROL PETITO ◽  
G. TOM SHIRES
Keyword(s):  
Carbon Monoxide ◽  
Diabetes Insipidus ◽  
Carbon Monoxide Poisoning ◽  
Smoke Inhalation

Cyanide: critical issues in diagnosis and treatment

2007 ◽  
Vol 26 (3) ◽  
pp. 191-201 ◽  
Author(s):  
F J Baud
Keyword(s):  
Carbon Monoxide ◽  
Terrorist Attack ◽  
Carbon Monoxide Poisoning ◽  
Signs And Symptoms ◽  
Clinical Situation ◽  
Diagnosis And Treatment ◽  
Cyanide Poisoning ◽  
Rescue Workers ◽  
Fire Victims ◽  
In Fire

The concern of a terrorist attack using cyanide, as well as the gradual awareness of cyanide poisoning in fire victims, has resulted in a renewed interest in the diagnosis and treatment of cyanide poisoning. The formerly academic presentation of cyanide poisoning must be replaced by more useful knowledge, which will allow emergency physicians and rescue workers to strongly suspect cyanide poisoning at the scene. Human cyanide poisonings may result from exposure to cyanide, its salts, or cyanogenic compounds, while residential fires are the most common condition of exposure. In fire victims, recognition of the cyanide toxidrome has been hampered by the short half-life in blood and poor stability of cyanide. In contrast, carboxyhemoglobin, as a marker of carbon monoxide poisoning, is easily measured and long-lasting. No evidence supports the assumption of the arbitrary fixed lethal thresholds of 50% for carboxyhemoglobin, and 3 mg/L for cyanide, in fire victims. Preliminary data, drawn when comparing pure carbon monoxide and pure cyanide poisonings, suggest that a cyanide toxidrome can be defined considering signs and symptoms induced by cyanide and carbon monoxide, respectively. Prospective studies in fire victims may provide value in clarifying signs and symptoms related to both toxicants. Cyanide can induce a lifethreatening poisoning from which a full recovery is possible. A number of experimentally efficient antidotes to cyanide exist, whose clinical use has been hampered due to serious side effects. The availability of potentially safer antidotes unveils the possibility of their value as first-line treatment, even in a complex clinical situation, where diagnosis is rapid and presumptive.

Extracorporeal support in an adult with severe carbon monoxide poisoning and shock following smoke inhalation: a case report

Perfusion ◽  
2000 ◽  
Vol 15 (2) ◽  
pp. 169-173 ◽  
Author(s):  
Maureen McCunn ◽  
H Neal Reynolds ◽  
Christine A Cottingham ◽  
Thomas M Scalea ◽  
Nader M Habashi
Keyword(s):  
Carbon Monoxide ◽  
Transitional Care ◽  
Carbon Monoxide Poisoning ◽  
Care Facility ◽  
Blood Gases ◽  
Smoke Inhalation ◽  
Cardiovascular Collapse ◽  
Prone Positioning ◽  
Life Threatening ◽  
Extracorporeal Support

The objective of this study was to discuss the case of a patient with severe smoke inhalation-related respiratory failure treated with extracorporeal support. The study was set in a 12-bed multi-trauma intensive care unit at a level one trauma center and hyperbaric medicine center. The patient under investigation had carbon monoxide poisoning, and developed acute respiratory distress syndrome and cardiovascular collapse following smoke inhalation. Rapid initiation of extracorporeal support, extreme inverse-ratio ventilation and intermittent prone positioning therapy were carried out. Admission and serial carboxyhemoglobin levels, blood gases, and computerized tomography of the chest were obtained. The patient developed severe hypoxia and progressed to cardiovascular collapse resistant to resuscitation and vasoactive infusions. Veno-venous extracorporeal support was initiated. Cardiovascular parameters of blood pressure, cardiac output, and oxygen delivery were maximized; oxygenation and ventilation were supported via the extracorporeal circuit. Airway pressure release ventilation and intermittent prone positioning therapy were instituted. Following 7 days of extracorporeal support, the patient was decannulated and subsequently discharged to a transitional care facility, neurologically intact. Smoke inhalation and carbon monoxide poisoning may lead to life-threatening hypoxemia associated with resultant cardiovascular instability. When oxygenation and ventilation cannot be achieved via maximal ventilatory management, extracorporeal support may prevent death if initiated rapidly.

Carbon monoxide poisoning in smoke inhalation

1990 ◽  
Vol 2 (4) ◽  
pp. 288-289
Author(s):  
Richard E. Moon ◽  
Claude A. Piantadosi
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Smoke Inhalation
Sign in / Sign up

Export Citation Format

Share Document