c yanide in f ire smoke presumptive - antidotal treatment
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C YANIDE IN F IRE SMOKE Presumptive - Antidotal Treatment. Cyanide’s Destructive Qualities. Blocks aerobic metabolism and energy production: cellular hypoxia Cells immediately starve for oxygen and die No amount of supplemental oxygen can overcome the deficit in affected cells - PowerPoint PPT PresentationTRANSCRIPT
CYANIDE IN FIRE SMOKE
Presumptive - Antidotal Treatment
Cyanide’s Destructive Qualities
Blocks aerobic metabolism and energy production: cellular hypoxia
– Cells immediately starve for oxygen and die– No amount of supplemental oxygen can
overcome the deficit in affected cells– Causes shift to anaerobic metabolism
Byproducts of anaerobic metabolism (e.g., lactic acid) accumulate
Death from central respiratory arrest
“Aftermath”
To address the complexities of HCN treatment, the Fire Smoke Coalition
produced “Aftermath” – a comprehensive video production about smoke inhalation, which
includes the presumptive diagnosis for consideration of cyanide
poisoning. This is not just about the firefighter population – it includes
civilians as well.
FDA Approved Cyanide Antidotes
CAK (Cyanide Antidote Kit) which contains Amyl Nitrite, Sodium Nitrite and Sodium Thiosulfate, is the most readily available antidote in most hospitals and the ONLY known to most physicians.
Which drug is contraindicated
In smoke inhalation patients?
FDA Approved CyanideAntidotes
- Nithiodote (a new cyanide antidote approved by the FDA in 2011) – but without new drugs (Sodium Nitrite and Sodium Thiosulfate) which will be marketed to hospitals for use as a new “cyanide antidote.”
Again, Nitrites.
FDA Approved CyanideAntidotes
-Cyanokit, which contains (2) 2.5mg vials of Hydroxocobalamin (Vitamin B12)- Not contraindicated in smoke inhalation victims and a preferred antidote by Coalition experts.
The Challenge: $$$ vs. Shelf Life (3yrs)
The Greatest Challenge with Cyanide Antidotes
Very few physicians and poison control centers are aware of the
difference between industrial cyanide poisoning and cyanide poisoning from
smoke inhalation AND, THEREFORE,
elect to use any “cyanide antidote” without understanding fire smoke
cyanide poisoning.
You are the Messenger
You, the firefighter / first responder, will be responsible for
educating your local medical community.
How?- Deliver a copy of “Aftermath”
- Share the “SMOKE publications
Does your Department need a life-saving cyanide
antidote? What good
is RIT without a Cyanokit?
Questions
www.Firesmoke.orgwww.FSCommunity.com