Cyanide poisoning treatment

Causes

• Exposure to sodium cyanide, potassium cyanide, or hydrogen cyanide.

Symptomology

Confusion from hypoxia and muscle pain from lactic acid buildup. Low blood oxygen, low blood pH.

Treatment

• Supplemental Oxygen, and
• IM or IV sodium thiosulfate and
• one, but not both of
  • IM or IV sodium nitrite --or--
  • IM or IV hydroxocobalamin

Warnings

• Do not co-administer hydroxocobalamin and nitrite.

Dosage

• Sodium nitrite: 300 mg intravenously (IV) at a rate of 25% to 50% perminute. IM is an acceptable alternative to IV.
• Sodium thiosulfate: 12.5 grams, slow IV. IM is an acceptable alternative to IV.
• Hydroxocobalamin 70 mg/kg (usually 5 g) IV infusion over 15 minutes; additional 5 g IV may be given depending on severity of poisoning and clinical response. Not to exceed a cumulative dose of 10 g. IM is an acceptable alternative to IV