sodium-nitrite and Carbon-Monoxide-Poisoning

Topics: Antidotes; Carbon Monoxide Poisoning; Cyanides; Drug Therapy, Combination; Humans; Hydroxocobalamin; Poisoning; Sodium Nitrite

Topics: Carbon Monoxide Poisoning; Carboxyhemoglobin; Cyanides; Humans; Poisoning; Sodium Nitrite

To evaluate serial cyanide, methemoglobin, and carbon monoxide levels in smoke inhalation patients.. Regional poison center and regional toxicology treatment center.. Seven critically ill smoke inhalation patients referred to the regional poison center.. Peak level and half-life were determined by obtaining serial carboxyhemoglobin, cyanide, and methemoglobin levels.. The mean observed half-life of cyanide was 3.0 +/- 0.6 hours. Methemoglobinemia was evaluated in four patients after sodium nitrite administration. The peak measured methemoglobin levels (mean, 10.5% +/- 2%; range, 7.9% to 13.4%) did not occur until a mean of 50 minutes (range, 35 to 70 minutes) following administration of sodium nitrite. The total oxygen-carrying capacity reduced by the combination of carboxyhemoglobin and methemoglobin was never more than 21% (range, 10% to 21%) in this series.. The administration of sodium nitrite to smoke inhalation patients in the presence of concomitant carbon monoxide poisoning may be relatively safe.

Topics: Adult; Antidotes; Carbon Monoxide Poisoning; Carboxyhemoglobin; Combined Modality Therapy; Cyanides; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Hyperbaric Oxygenation; Infusions, Intravenous; Male; Methemoglobin; Methemoglobinemia; Middle Aged; Poison Control Centers; Poisoning; Prospective Studies; Smoke Inhalation Injury; Sodium Nitrite; Thiosulfates; Time Factors

Management of the acutely poisoned patient should start with decontamination of the skin and irrigation of the eyes, if necessary, and assessment of cardiorespiratory status, neurologic status, and pupils and eye movement. If a definable toxic syndrome is present, the specific "antidote" should be given. If no such syndrome is apparent and the patient is comatose, 50 ml of 50% glucose and 0.4 mg of naloxone (Narcan) intravenously should be tried. General measures, applicable in either situation, include induction of emesis or lavage and administration of charcoal and cathartics.

Topics: Acute Disease; Antidotes; Carbon Monoxide Poisoning; Consciousness; Cyanides; Depression, Chemical; Humans; Naloxone; Nitrates; Nitrites; Organophosphate Poisoning; Oxygen; Parasympatholytics; Poisoning; Pupil; Sodium Nitrite; Thiosulfates