The Role of Cyanide
in Smoke Inhalation:

Description

While carbon monoxide poisoning is a commonly suspected cause of smoke inhalation-associated injury and death, hydrogen cyanide poisoning is often overlooked. Because of the pervasiveness and rapid onset of cyanide poisoning, preventing death depends heavily upon the time between exposure and treatment.

This teaching tool will help emergency clinicians gain a better understanding and provide more accurate, timely diagnoses and improve treatment management for patients with acute cyanide poisoning and gain increased awareness of the therapeutic effects on patient outcomes.

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Target Audience

This educational activity has been developed for physicians and other health care providers, including nurses, who treat patients with cyanide poisoning.

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Learning Objectives

After completing this activity, learners will be able to:

• Understand sources of exposure to cyanide poisoning
• Appreciate the underdiagnosis of cyanide poisoning, especially as it relates to smoke inhalation
• Describe the symptoms of cyanide poisoning and the need for rapid, empiric treatment
• Discuss antidotes and emerging therapies for cyanide poisoning as important resources for EMS responders, toxicologists, and emergency department physicians

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PROGRAM OVERVIEW

The two greatest threats in fire smoke are carbon monoxide and hydrogen cyanide. Colorless and odorless, both gases can incapacitate within seconds. Fire victims overcome by one or both agents often die before help reaches them. While carbon monoxide poisoning is a commonly suspected cause of smoke inhalation-associated injury and death, hydrogen cyanide poisoning is often overlooked.

Acute cyanide poisoning is a growing concern in the fire and emergency medicine communities. Studies have shown the most common—and an increasingly frequent—source of acute cyanide poisoning is smoke inhalation. Research has clarified cyanide’s contribution to smoke inhalation-associated morbidity and mortality. Because of the pervasiveness and rapid onset of cyanide poisoning, preventing death depends heavily upon the time between exposure and treatment. Based on these characteristics, cyanide also poses a significant terrorist threat. In light of such compelling evidence, why is the potential role of cyanide in fire smoke toxicity so often minimized or ignored?

The teaching tool The Role of Cyanide in Smoke Inhalation: New Treatment for a Silent Killer will disseminate the most recent and relevant information available on the increasingly common occurrence of acute cyanide poisoning in smoke inhalation victims. Recognizing the current lack of an antidote suitable for rapid prehospital administration in the United States, the program will focus on existing medical management as well as an emerging approach to treatment and intervention that potential makes early, empiric, out-of-hospital care a promising defense.

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ACCREDITATION STATEMENT
AND CREDIT DESIGNATION

INNOVIA Education Institute, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

INNOVIA Education Institute designates this educational activity for a maximum of 1.75 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

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FACULTY

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FACULTY DISCLOSURES

Marc Eckstein, MD, FACEP:
Dr. Eckstein is a member of the advisory board for EMD.

Donald W. Walsh, PhD, EMT-P:
Dr. Walsh has served as a subject matter expert/consultant for EMD and Dey.

Content collaborators at INNOVIA Education Institute have disclosed no relevant financial relationships.

The peer reviewer for this activity, Cai Glushak, MD, has disclosed no relevant financial relationships.

Uses of some pharmaceutical agents, medical devices, and other products identified in this activity may not be the same as those indicated in product labeling approved by the Food and Drug Administration. INNOVIA requires that any discussions of such "off-label" uses be based on scientific research that conforms to generally accepted standards of experimental design, data collection, and data analysis. The following faculty report discussion of off-label uses of pharmaceutical or medical device products in their presentations: Dr. Marc Eckstein, Dr. Donald W. Walsh.

INNOVIA Education Institute is committed to the free exchange of medical information in the interest of improvement in the quality and safety of patient care. Opinions, recommendation, and other discussions in this activity, including discussion of off-label uses, represent the independent views of the presenters/authors and not an endorsement by INNOVIA Education Institute.

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ACKNOWLEDGEMENT OF LEARNERS' EXPECTATIONS

INNOVIA Education Institute, LLC, recognizes that you are a lifelong learner who has chosen to engage in continuing medical education (CME) to help maintain, improve, increase, or otherwise enhance your knowledge and skills in the practice of medicine. As part of INNOVIA’s duty to you as a learner, we acknowledge your right to expect that this CME activity includes:

Content that

• Addresses stated objectives or purpose
• Is valid, reliable, and accurate
• Is driven by, and based on, educational needs rather than commercial interests
• Is balanced and free of commercial bias for or against a product or service
• Is vetted through a process to resolve any conflicts of interest of planners, presenters, or authors
• Is evaluated for its effectiveness in meeting identified educational needs
• Provides information toward improvements in the quality and safety of health care

An environment that

• Supports learners' abilities to meet their individual educational needs
• Respects and attends to any special learner needs
• Respects diversity among learners
• Is free of promotional, commercial, and/or sales activities

Disclosure of

• Relevant financial relationships that planners, presenters, or authors have with commercial interests related to the content of the activity
• Commercial support (funding or in-kind resources) for the activity

We hope that this activity has fulfilled the expectations listed above. If it has not, please respond to that effect on the evaluation form and include specific feedback to assist us with making improvements to future activities.

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EARN CREDIT

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