Presentation
300mg in 10mL ampoule
SAS
Role
- Management of severe cyanide poisoning evidenced by altered level of consciousness, seizures, hypotension or significant acidosis.
- Given in conjunction with sodium thiosulphate in moderate to severe toxicity, where hydroxocobalamin (Cyanokit 5g) is not available.
Consultation with a clinical toxicologist is recommended through the local toxicology service or Poisons Information Centre 13 11 26.
Dose
300mg IV over 5 minutes (children 4-10mg/kg), repeat half of this dose at 30mins if no clinical improvement.
Stocking recommendations
Tertiary centre | Regional centre | Rural centre | Remote centre |
---|---|---|---|
0-5 ampoules | 0-5 ampoules | 0-2 ampoules | 0 ampoules |
Rationale
If available, hydroxocobalamin (Cyanokit 5g) is the preferred antidote for cyanide poisoning. Sodium thiosulfate plus sodium nitrite are an acceptable alternative if hydroxocobalamin is unavailable
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