{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T22:45:50Z","timestamp":1778453150670,"version":"3.51.4"},"reference-count":44,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2011,11,26]],"date-time":"2011-11-26T00:00:00Z","timestamp":1322265600000},"content-version":"unspecified","delay-in-days":56,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prehosp. Disaster med."],"published-print":{"date-parts":[[2011,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Enclosed-space smoke inhalation is the fifth most common cause of all unintentional injury deaths in the United States. Increasingly, cyanide has been recognized as a significant toxicant in many cases of smoke inhalation. However, it cannot be emergently verified. Failure to recognize the possibility of cyanide toxicity may result in inadequate treatment. Findings suggestive cyanide toxicity include: (1) a history of an enclosed-space fire scene in which smoke inhalation was likely; (2) the presence of oropharyngeal soot or carbonaceous expectorations; (3) any alteration of the level of consciousness, and particularly, otherwise inexplicable hypotension (systolic blood pressure \u226490 mmHg in adults). Prehospital studies have demonstrated the feasibility and safety of empiric treatment with hydroxocobalamin for patients with suspected smoke inhalation cyanide toxicity. Although United States Food and Drug Administration (FDA)-approved since 2006, the lack of efficacy data has stymied the routine use of this potentially lifesaving antidote. Based on a literature review and on-site observation of the Paris Fire Brigade, emergency management protocols to guide empiric and early hydroxocobalamin administration in smoke inhalation victims with high-risk presentations are proposed.<\/jats:p>","DOI":"10.1017\/s1049023x11006625","type":"journal-article","created":{"date-parts":[[2012,2,15]],"date-time":"2012-02-15T13:42:08Z","timestamp":1329313328000},"page":"374-382","source":"Crossref","is-referenced-by-count":32,"title":["Empiric Management of Cyanide Toxicity Associated with Smoke Inhalation"],"prefix":"10.1017","volume":"26","author":[{"given":"Daniel J.","family":"O\u2019Brien","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald W.","family":"Walsh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colleen M.","family":"Terriff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan H.","family":"Hall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2011,11,26]]},"reference":[{"key":"S1049023X11006625_ref032","first-page":"118","article-title":"Study of the mechanisms involved in hydroxocobalamin interference with determination of some biochemical parameters","volume":"52","author":"Gourlain","year":"1994","journal-title":"Ann Biol Clin (Paris)"},{"key":"S1049023X11006625_ref024","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2007.10.012"},{"key":"S1049023X11006625_ref038","first-page":"709","article-title":"Outcome following organ removal from poisoned donors in brain death status: A report of 12 cases and review of the literature","volume":"33","author":"Hantson","year":"1995","journal-title":"Clin Toxicol"},{"key":"S1049023X11006625_ref011","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198802000-00007"},{"key":"S1049023X11006625_ref041","unstructured":"US Food and Drug Administration: FDA news: FDA approves drug to treat cyanide poisoning. 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