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Related Concept Videos

Pharmaceutical Poisoning: Treatment Strategies01:26

Pharmaceutical Poisoning: Treatment Strategies

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Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
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Pharmaceutical Poisoning: Potential Scenarios01:26

Pharmaceutical Poisoning: Potential Scenarios

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Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
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Hypoxia01:23

Hypoxia

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Hypoxia is a medical condition characterized by an inadequate oxygen supply to body tissues. It typically manifests as a bluish discoloration of the skin and mucosae, especially in fair-skinned individuals, when hemoglobin (Hb) saturation drops below 75%.
Types of Hypoxia
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Prevention of Further Absorption of Poison01:14

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In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
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Antidotes01:17

Antidotes

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Antidotes are medicinal substances used to counteract the harmful effects of toxins or drugs in the body. They function in various ways, each uniquely designed to combat specific toxic compounds.
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Intravenous Hydroxocobalamin for Cyanide Poisoning From Smoke Inhalation: A Comprehensive Scoping Review.

Robert Dunne1, Jeffrey M Goodloe2, James J Augustine3

  • 1St. John Hospital and Medical Center and Wayne State University School of Medicine, Detroit, Michigan, USA.

Journal of the American College of Emergency Physicians Open
|March 9, 2026
PubMed
Summary
This summary is machine-generated.

Hydroxocobalamin is a potential treatment for hydrogen cyanide (HCN) poisoning from smoke inhalation. This review found it was generally well-tolerated and linked to better survival, but more research is needed.

Keywords:
cyanide poisoninghydroxocobalamininhalation injurysmoke inhalation

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Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pharmacology

Background:

  • Hydrogen cyanide (HCN) exposure from smoke inhalation is a significant cause of death in burn victims.
  • Hydroxocobalamin is recommended for HCN poisoning, but real-world data, especially prehospital use, is limited.

Purpose of the Study:

  • To review existing literature on hydroxocobalamin administration for HCN toxicity due to smoke inhalation.
  • To identify patterns in its real-world use, clinical outcomes, and adverse events.

Main Methods:

  • A scoping review of BIOSIS Previews, Embase, PubMed, and MEDLINE was conducted.
  • Data from 21 papers involving 512 patients were analyzed, focusing on demographics, dosing, clinical data, and adverse events.

Main Results:

  • Hydroxocobalamin was used prehospital in 45.9% of cases, typically at 5 or 10 g doses.
  • Common adverse events included chromaturia and skin discoloration; acute kidney injury was also reported.
  • Of 482 patients with known survival, 66.0% survived to hospital discharge.

Conclusions:

  • Hydroxocobalamin appears generally well-tolerated and associated with favorable outcomes in smoke inhalation-related HCN toxicity.
  • Evidence remains observational and heterogeneous, highlighting critical gaps and variability in its real-world application.
  • Further research is necessary to understand and address barriers to hydroxocobalamin use.