Is Hydroxocobalamin Safe and Effective for Smoke Inhalation? Searching for Guidance in the Haze

Abstract

SEE RELATED ARTICLES, P. 794, 802, 806. Prospective Study of Hydroxocobalamin for Acute Cyanide Poisoning in Smoke InhalationAnnals of Emergency MedicineVol. 49Issue 6PreviewTo assess outcomes in patients treated with hydroxocobalamin at the fire scene or in the ICU for suspected smoke inhalation-associated cyanide poisoning. Full-Text PDF Potential Interference by Hydroxocobalamin on Cooximetry Hemoglobin Measurements During Cyanide and Smoke Inhalation TreatmentsAnnals of Emergency MedicineVol. 49Issue 6PreviewConcentrated aqueous solutions of hydroxocobalamin (OHCob) are administered intravenously for cyanide poisoning victims, many of whom also have concurrent smoke inhalation. Because of its intense light absorbance in visible wavelengths (absorption peak at 532 nm), we investigate potential interference effects of OHCob on total hemoglobin concentration (tHb), carboxyhemoglobin (COHb), methemoglobin (MetHb), and oxyhemoglobin (Hb-O2) cooximetry measurement values in blood. Full-Text PDF Sodium Thiosulfate or Hydroxocobalamin for the Empiric Treatment of Cyanide Poisoning?Annals of Emergency MedicineVol. 49Issue 6PreviewCyanide poisoning must be seriously considered in victims of smoke inhalation from enclosed space fires; it is also a credible terrorism threat agent. The treatment of cyanide poisoning is empiric because laboratory confirmation can take hours or days. Empiric treatment requires a safe and effective antidote that can be rapidly administered by either out-of-hospital or emergency department personnel. Among several cyanide antidotes available, sodium thiosulfate and hydroxocobalamin have been proposed for use in these circumstances. Full-Text PDF Correction NoticeAnnals of Emergency MedicineVol. 50Issue 2Preview Full-Text PDF