Presence of soot around the mouth, nose, or oropharynxĪlthough hypotension is highly suggestive of cyanide poisoning, it is only present in a small percentage of cyanide-poisoned smoke inhalation victims.

Exposure to fire or smoke in an enclosed area.

Prior to administration of Sodium Thiosulfate Injection, smoke-inhalation victims should be assessed for the following: Not all smoke inhalation victims will have cyanide poisoning and may present with burns, trauma, and exposure to other toxic substances making a diagnosis of cyanide poisoning particularly difficult.

Sodium thiosulfate is chemically incompatible with hydroxocobalamin and should not be administered via the same intravenous line.

Monitoring: Blood pressure must be monitored during treatment.

Redosing: If signs of cyanide poisoning reappear, repeat treatment using one-half the original dose of both sodium nitrite and sodium thiosulfate.

Intravenous Dose of Sodium Nitrite and Sodium Thiosulfateġ.) Sodium Nitrite -10 mL of sodium nitrite at the rate of 2.5 to 5 mL/minute 2.) Sodium Thiosulfate - 50 mL of sodium thiosulfate immediately following administration of sodium nitrite.ġ.) Sodium Nitrite - 0.2 mL/kg (6 mg/kg or 6-8 mL/m 2 BSA) of sodium nitrite at the rate of 2.5 to 5 mL/minute not to exceed 10 mL 2.) Sodium Thiosulfate - 1 mL/kg of body weight (250 mg/kg or approximately 30-40 mL/m 2 of BSA) not to exceed 50 mL total dose immediately following administration of sodium nitrite.

The expert advice of a regional poison control center may be obtained by calling 1-80.

If clinical suspicion of cyanide poisoning is high, administer Sodium Thiosulfate Injection without delay and in conjunction with appropriate airway, ventilatory, and circulatory support.

Sodium thiosulfate antidote