Toxicology Notes: Considerations for Cyanide Treatment in the Emergency Department

While working the overnight shift a child is brought in to your emergency department from a house fire. His burns are minor, but he was found in the house and likely had a significant smoke inhalation. The paramedics have started oxygen therapy, and as an astute emergency physician you add a blood gas with cooximetry, lactate and cyanide level to your initial orders. You are preparing to administer the CYANOKIT (hydroxocobalamin) but you pause for a moment to ask, “Should I be sending additional labs before I give this medications? Will this affect management in the next 24 hours? Are there other options?” read more