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Cyanide Poisoning

Date Last Search Run: Feb 01, 2022
Table last updated: Apr 02, 2022
Data last added: Mar 27, 2022

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)        
2 (fair evidence exists)      
3 (weak evidence exists)    


Interventions

Hydroxocobalamin
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Safety Patient SIM Uhl W, Nolting A, Golor G, Rost KL, Kovar A. Safety of hydroxocobalamin in healthy volunteers in a randomized, placebo-controlled study. Clin Toxicol (Phila) 2006; 44 Suppl 1:17-28. Medline
III Supportive (Green) Survival & recovery Patient PH-Paramedic Borron SW, Baud FJ, Barriot P, Imbert M, Bismuth C. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg Med 2007; 49(6):794-801, 801.e1. Medline
III Supportive (Green) Cyanide level improvement Patient Other Dinh D, Rosini JM. Empiric treatment of cyanide toxicity in an enclosed-space fire survivor. J Emerg Nurs 2014; 40(3):282-5; quiz 293. Medline
III Supportive (Green) Survival Patient PH-Paramedic & MD Fortin JL, Giocanti JP, Ruttimann M, Kowalski JJ. Prehospital administration of hydroxocobalamin for smoke inhalation-associated cyanide poisoning: 8 years of experience in the Paris Fire Brigade. Clin Toxicol (Phila) 2006; 44 Suppl 1:37-44. Medline
III Neutral (Yellow) Indication for use Process PH-Paramedic Cumpston KL, Rodriguez V, Nguyen T, MacLasco A, Zin C, Rutherfoord Rose S, et al. Evaluation of prehospital hydroxocobalamin use in the setting of smoke inhalation. Am J Emerg Med 2021; 50:365–8. Medline
III Neutral (Yellow) Survival Patient ED-MD Davies V, Turner J, Greenway M. Toxic inhalational injury. BMJ Case Rep 2020; 13(3). Medline
III Neutral (Yellow) Utility Process ED-MD Mastenbrook J, Zamihovsky R, Brunken N, Olsen T. Intraosseous administration of hydroxocobalamin after enclosed structure fire cardiac arrest. BMJ Case Rep 2021; 14(3). Medline
III Opposes (Red) Development of acute kidney injury Patient ICU Pruskowski KA, Britton GW, Cancio LC. Outcomes after the administration of hydroxocobalamin. Int J Burns Trauma 2020; 10(5):231-36. Medline


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