title: Cyanide poisoning by fire smoke inhalation:  a European expert consensus.
abstract: Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant toxicant. The diagnosis of cyanide poisoning remains very difficult, and failure to recognize it may result in inadequate or inappropriate treatment. Findings suggesting cyanide toxicity include the following: (a) a history of enclosed-space fire; (b) any alteration in the level of consciousness; (c) any cardiovascular changes (particularly inexplicable hypotension); and (d) elevated plasma lactate. The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims.
authors: Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium. kurtanseeuw@yahoo.com
authors: Kurt
authors: K
authors: Anseeuw
authors: Nicolas
authors: N
authors: Delvau
authors: Guillermo
authors: G
authors: Burillo-Putze
authors: Fabio
authors: F
authors: De Iaco
authors: Götz
authors: G
authors: Geldner
authors: Peter
authors: P
authors: Holmström
authors: Yves
authors: Y
authors: Lambert
authors: Marc
authors: M
authors: Sabbe
mesh_terms: D000465:Algorithms; D002619:Chemical Warfare Agents / Q000506:poisoning*; D002985:Clinical Protocols; D003697:Delphi Technique; D004632:Emergency Medical Services; D005060:Europe; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D006856:Hydrogen Cyanide / Q000506:poisoning*; D006879:Hydroxocobalamin / Q000627:therapeutic use; D012906:Smoke / Q000032:analysis; D015208:Smoke Inhalation Injury / Q000150:complications* / Q000188:drug therapy
chemical_list: D002619:Chemical Warfare Agents; D006397:Hematinics; D012906:Smoke; D006856:Hydrogen Cyanide; D006879:Hydroxocobalamin