New! – Smoke Inhalation Protocols – PDM

The moment we’ve all been waiting for – new smoke inhalation treatment protocols. Drs. Dan O’Brien, Donald Walsh, Alan Hall and Colleen M. Terriff, PharmD, BCPS, have authored new treatment protocols. Immediately share this document with your medical directors and local hospitals. This is new life-saving medicine. Empiric Management of Cyanide Toxicity Associated with Smoke Inhalation.

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PATHOLOGY & TOXICOLOGY

Below are resources and publications specific to the pathology and toxicology subject. To view member-only content, please visit our Become a Member section to learn more about joining the Fire Smoke Coalition.

Hydroxocobalamin use in the ED? – The Expert’s Answer

Question to an Expert: (Dr. Alan Hall) Should Hydroxocobalamin have been administered in the ED? A recent clinical case came up where Hydroxocobalamin was discussed. Based on the following, what would you have done (the patient recovered)? Patient was pulled from a house fire with his roommate. The patient was reported unconscious at the scene [...]

FF Deaths – Lethal Levels of HCN

On Thursday, February 19, 2009, Craigsville-Beaver-Cottle Fire Department in Nicholas County, West Virginia lost Lt. Johnnie Howard Hammons and FF Timothy Allen Nicholas during fire suppressions operations. Both were experienced firefighters, according to records ( http://www.register-herald.com/archivesearch/local_story_051234439.html ). According to the medical examiner’s office, the victims died from smoke inhalation and thermal inhalation. The carboxyhemoglobin (carbon monoxide [...]

Safety of Hydroxocobalmin in Healthy Volunteers in a Randomized, Placebo-Controlled Study

Inhalation of fire smoke, occupational exposure, industrial accidents, suicide and murder attempts, accidental ingestion, chemical warfare, and terrorism are among the causes of acute cyanide poisoning, which can result in death in minutes to hours depending mainly on cyanide concentration and route of exposure. For the victim of acute cyanide poisoning, timely intervention with an [...]

Nitric Oxide Scavenging By Hydroxocobalamin May Account for Its Hemodynamic Profile

The hemodynamic profile of hydroxocobalamin differs from that of the Cyanide Antidote Kit, which can produce potentially lethal hypotension. Hydroxocobalamin, the active form of Vitamin B , acts by trapping cyanide ions and thereby forming 12 cyanocobalamin. Hydroxocobalamin has been associated with increases in blood pressure in studies in animals and humans. Transient, self-limiting increases in blood pressure were [...]

Cyanide & Modern Fires: Scientific and Practical Fundamentals for Fire Service Professionals

The contribution of hydrogen cyanide to smoke inhalation-associated injury and death has historically been overshadowed by a focus on carbon monoxide, another important toxicant in fire smoke. However, the role of cyanide is becoming better understood everyday as the body of evidence establishing its pervasiveness as a combustion product and its toxicity in the fire [...]