Snapshot A 60-year-old man presents to the emergency room after being caught in a fire. He woke up in the middle of the night to sirens blaring and discovered smoke from the neighboring apartment. He, along with other residents, was brought to the hospital for further evaluation. He reports having some dizziness and headaches. On exam, his lungs are clear to auscultation and there is no erythema in his throat. His cheeks are cherry-red in color and his lips are cyanotic. His oxygen level is 85% and does not improve with oxygen supplementation. He is started on hydroxocobalamin and thiosulfate for cyanide poisoning. He is also continued on 100% oxygen for carbon monoxide poisoning as well. Introduction Clinical definition login to view 1 more bullet Etiology Cyanide poisoning can occur from many exposures, including inhalation, ingestion, or direct contact login to view 11 more bullets Pathogenesis login to view 4 more bullets Epidemiology Incidence login to view 1 more bullet Presentation Symptoms login to view 5 more bullets Physical exam login to view 10 more bullets Studies Diagnostic testing login to view 7 more bullets Differential Carbon monoxide poisoning login to view 3 more bullets Salicylate poisoning login to view 3 more bullets DIAGNOSIS Making the diagnosis login to view 1 more bullet Treatment Management approach login to view 4 more bullets First-line login to view 4 more bullets Second-line login to view 3 more bullets Other treatments login to view 3 more bullets Complications Parkinsonism login to view 1 more bullet Prognosis Can be rapidly fatal if untreated