title: Pediatric cyanide poisoning by fire smoke inhalation: a European expert consensus. Toxicology Surveillance System of the Intoxications Working Group of the Spanish Society of Paediatric Emergencies.
abstract: Most fire-related deaths are attributable to smoke inhalation rather than burns. The inhalation of fire smoke, which contains not only carbon monoxide but also a complex mixture of gases, seems to be the major cause of morbidity and mortality in fire victims, mainly in enclosed spaces. Cyanide gas exposure is quite common during smoke inhalation, and cyanide is present in the blood of fire victims in most cases and may play an important role in death by smoke inhalation. Cyanide poisoning may, however, be difficult to diagnose and treat. In these children, hydrogen cyanide seems to be a major source of concern, and the rapid administration of the antidote, hydroxocobalamin, may be critical for these children.European experts recently met to formulate an algorithm for prehospital and hospital management of adult patients with acute cyanide poisoning. Subsequently, a group of European pediatric experts met to evaluate and adopt that algorithm for use in the pediatric population.
authors.affiliation: From the *Pediatric Emergency Department, Cruces University Hospital, Barakaldo, and University of the Basque Country, and †Pediatric Emergency Care, Navarra Hospital Complex, Pamplona, Spain; ‡Pediatric Emergency Department, Azienda Ospedaliera di Rilievo Nazionale Santobono-Pausilipon di Napoli, Napoli; and §Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, IRCCS Maugeri Foundation, Pavia, Italy; ∥Department of Emergency Medicine, Hospital Universitario de Canarias, Tenerife, Spain; and ¶Department of Emergency Medicine, Cliniques Universitaires Saint-Luc, Brussels; and #Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium.
authors.forename: Santiago
authors.initials: S
authors.lastname: Mintegi
authors.forename: Nuria
authors.initials: N
authors.lastname: Clerigue
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tipo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ponticiello
authors.forename: Davide
authors.initials: D
authors.lastname: Lonati
authors.forename: Guillermo
authors.initials: G
authors.lastname: Burillo-Putze
authors.forename: Nicolas
authors.initials: N
authors.lastname: Delvau
authors.forename: Kurt
authors.initials: K
authors.lastname: Anseeuw
mesh_terms: D015761:4-Aminopyridine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000367:Age Factors; D000465:Algorithms; D000931:Antidotes / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003486:Cyanides / Q000097:blood / Q000506:poisoning*; D019468:Disease Management; D004198:Disease Susceptibility; D004630:Emergencies; D004632:Emergency Medical Services / Q000592:standards*; D005060:Europe; D005390:Fires; D006801:Humans; D006879:Hydroxocobalamin / Q000008:administration & dosage / Q000627:therapeutic use; D007223:Infant; D008708:Methemoglobinemia / Q000139:chemically induced; D011041:Poisoning / Q000175:diagnosis / Q000188:drug therapy; D012906:Smoke / Q000032:analysis*; D015208:Smoke Inhalation Injury / Q000453:epidemiology / Q000209:etiology*; D012977:Sodium Nitrite / Q000009:adverse effects / Q000627:therapeutic use; D013885:Thiosulfates / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000931:Antidotes; D003486:Cyanides; D012906:Smoke; D013885:Thiosulfates; D015761:4-Aminopyridine; D012977:Sodium Nitrite; C003885:4-dimethylaminopyridine; D006879:Hydroxocobalamin