title: Hydrogen cyanide poisoning in a prison environment: a case report.
abstract: Cyanide poisoning is an important source of morbidity and mortality from smoke exposure in structural fires. This case involved administration of a cyanide antidote to a prisoner (male, 23 years) in France, discovered in cardiorespiratory arrest after about 30 minutes exposure to smoke from a burning mattress during an apparent suicide attempt. Smoke exposure, circulatory failure during initial resuscitation, and elevated blood cyanide and lactate led to the diagnosis of cyanide poisoning. Hydroxocobalamin (Cyanokit®), 5 g intravenous) was given immediately and on arrival at the hospital. Cardiopulmonary resuscitation restored cardiovascular function after 33 minutes. There were no neurological or other sequelae. Timely hydroxocobalamin administration contributed to full recovery from cardiorespiratory arrest secondary to cyanide poisoning from smoke inhalation. Hydroxocobalamin should be available to emergency medical teams attending fire scenes.
authors.affiliation: Emergency Department, Jean Minjoz University Hospital, Besançon, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Fortin
authors.forename: Virginie
authors.initials: V
authors.lastname: Judic-Peureux
authors.forename: Thibault
authors.initials: T
authors.lastname: Desmettre
authors.forename: Cyril
authors.initials: C
authors.lastname: Manzon
authors.forename: Daniel
authors.initials: D
authors.lastname: Grimon
authors.forename: Ulrike
authors.initials: U
authors.lastname: Hostalek
authors.forename: Christine
authors.initials: C
authors.lastname: Fétro
authors.forename: Gilles
authors.initials: G
authors.lastname: Capellier
mesh_terms: D003422:Critical Care / Q000379:methods; D004562:Electrocardiography; D005602:France; D006323:Heart Arrest / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D006856:Hydrogen Cyanide / Q000008:administration & dosage / Q000097:blood / Q000506:poisoning*; D006879:Hydroxocobalamin / Q000008:administration & dosage / Q000627:therapeutic use; D001239:Inhalation; D008297:Male; D011329:Prisoners; D012906:Smoke / Q000009:adverse effects; D055815:Young Adult
chemical_list: D012906:Smoke; D006856:Hydrogen Cyanide; D006879:Hydroxocobalamin