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Association: Name: National Association of EMS Physicians URL: http://www.naemsp.org
Citation: URL: http://www.allacademic.com/meta/p64880_index.html Direct Link: HTML Code:

Fortin, Jean-Luc., Turrimann, M., Domanski, L. and Kowalski, JJ. "Hydroxocobalamin for Smoke Inhalation-Associated Cyanide Poisoning: 8 Years of Experience in the Paris Fire Brigade" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL, <Not Available>. 2009-05-25 <http://www.allacademic.com/meta/p64880_index.html>

Fortin, J. , Turrimann, M. , Domanski, L. and Kowalski, J. "Hydroxocobalamin for Smoke Inhalation-Associated Cyanide Poisoning: 8 Years of Experience in the Paris Fire Brigade" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL <Not Available>. 2009-05-25 from http://www.allacademic.com/meta/p64880_index.html

Publication Type: Abstract Abstract: Background: The cyanide antidote hydroxocobalamin has been used for decades in France. Hydroxocobalamin is being studied for possible introduction in the United States to address the need for an antidote with potential for prehospital treatment of cyanide poisoning from smoke inhalation and other causes. This abstract reports the results of a retrospective study of 8 years of experience of the Paris Fire Brigade with the prehospital use of hydroxocobalamin. Methods: The head physician at the Paris Fire Brigade extracted and summarized data from standardized forms completed at the fire scene and, when available, hospital reports to assess outcomes associated with hydroxocobalamin for each patient who received it for smoke inhalation-associated cyanide poisoning from 1995 to 2003. Results : Of the 101 patients administered hydroxocobalamin, 30 survived, 42 died (17 at the fire scene and 25 at the intensive-care unit), and outcomes were not known in the remaining 29 patients. Of the 38 patients found in cardiac arrest, 21 (55.3%) had a return of spontaneous circulation during prehospital care. Of the 12 patients who were initially hemodynamically unstable (systolic blood pressure 0 to £90 mmHg), 9 (75%) recovered systolic blood pressure an average of 30.6 minutes after the start of hydroxocobalamin infusion. Among nonsedated patients in the sample as a whole (n=52), mean (SD) Glasgow coma scale score improved from 7.9 (5.4) initially to 8.5 (5.7) after administration of hydroxocobalamin. Among nonsedated patients who initially were neurologically impaired (n=18), Glasgow coma scale score improved in 9 patients, did not change in 8 patients, and worsened in 1 patient. Two adverse events—red or pink coloration of urine or skin (n=5) and cutaneous rash (n=1)—were assessed as being possibly related to hydroxocobalamin. Conclusion: Hydroxocobalamin has a risk:benefit ratio rendering it suitable for prehospital use in the management of acute cyanide poisoning caused by smoke inhalation.

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