How are you giving this, Tim, adn what dose ?
It would be good if an adequate hydroxycobalamin were available,
but the 1mg or so doses available in the UK as an im injection is by
no means adequate to counteract a symptomatic level of cyanide
intoxication. The French and other European countries can use much
larger doses iv, but only a few places in the UK ( NPIS London to
my knowledge ) have supplies of it. As I understand, toxicologists
differ as to the advisability of stocking it.
Paul Ransom
On 13 Oct 2005, at 11:07, Coats Tim - Professor of Emergency Medicine
wrote:
> For smoke inhalation I measure CO but not usually lactate, and give
> hydroxycobalamine to anyone with a depressed level of consciousness.
> Tim.
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of Rowley Cottingham
> Sent: 12 October 2005 22:29
> To: [log in to unmask]
> Subject: Re: Smoke inhalation & lactate
>
>
> CO yes, lactate no. Cyanide poisoning is a binary event and if you
> get to
> hospital breathing you will continue to do so. CO poisoning is an
> altogether
> more subtle affair, and needs to be assiduously sought.
>
> Best wishes
>
>
> Rowley.
>
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Scott, Charles
> Sent: 12 October 2005 11:30
> To: [log in to unmask]
> Subject: Smoke inhalation & lactate
>
>
> Does anyone routinely measure blood lactate levels in patients
> involved in
> fires where smoke inhalation may have happened in the absence of
> any signs
> to suggest Cyanide poisoning? Lactate is part of the investigation
> on the
> Toxbase site (" If lactate concentration > 10 mmol/L in absence of
> significant burns and after correct of hypotension consider the
> possibility
> of cyanide poisoning." sic) And do you always measure CO levels in
> everyone
> involved in a house fire?
>
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