To kick-off this month, the topic for this week is on the Cyanokit®. Asst. Director of EMS, Jim Gray, Bolingbrook Fire Department, submitted an article about his department's process for securing the Cyanokit® and a recent save.
In December of 2011 the Chief of our department approached the EMS division and asked us to research a cyanide antidote. He read an article in a publication that talked about how the Houston Fire Department had utilized a cyanide antidote, the Cyanokit®, which saved the life of one of their own. My knowledge was limited regarding Hydrogen Cyanide and the Cyanokit. I thought it would be a quick research project but I was wrong about that. The more I researched Hydrogen Cyanide and the Cyanokit (Hydroxocobalamin) the more surprised I was to find what it is all about. We are all familiar with Carbon Monoxide, however I was amazed at the information I found about Hydrogen Cyanide and its deadly combination with Carbon Monoxide which creates the Toxic Twinsâ¢. I was amazed at the number of people who were educated on this topic. Departments that have used the Cyanokit were sold on it.
Many of the experts I talked to about getting the Cyanokit® stated that the hardest part would be selling the medical director. Fortunately that was not a problem for our departments. Our MABAS division is covered by two different resource hospitals with two separate medical directors. I provided the data to our resource hospital, and they were on board. We have a very progressive EMS system and our medical director is supportive of our ideas. Once it was approved by the Edward Hospital medical system the next step was getting it approved by the Illinois Department of Public Health. While it was going through the IDPH, we went to our MABAS division Chiefsâ meeting and presented all the information. Every chief was sold on the idea and agreed to purchase 2 Cyanokits to keep in service on their command vehicles. The MABAS division consists of Bolingbrook, Naperville, Lisle Woodridge, and Downers Grove Fire Departments. That gives us 8 kits to utilize when needed. The overall process for approving the Cyanokit® took about 4 months.
Recently on April 13, 2013 the Bolingbrook Fire Department had a residential structure fire. This was just shortly a year after implementing the Cyanokit® protocol. There were reports of somebody trapped inside the house while en route to the fire. The initial crew arrived to find the house on fire with smoke banked down to the floor. They entered the structure and found a victim approximately 10 feet inside the rear door of the house. The victim was pulled out and advance life support procedures were started including intubation and administration of the Cyanokit®. The victim was unresponsive with agonal respirations and the presence of soot around and in his mouth. He was transported to Adventist Bolingbrook Hospital emergency room and then later transferred to a hospital with a hyperbaric chamber. There was not a specific blood draw done at the hospital for Hydrogen Cyanide, however the doctor stated that the labs revealed acidosis an indicator for cyanide poisoning. The doctor applauded the efforts of the crew in administering the Cyanokit®. I am happy to report as of today, almost a month after the incident, the patient is alive and doing well at home. We believe that the administration of the Cyanokit® potentially saved the life of one of our residents.
We are very excited to have the Cyanokit® in service, not only our department but the entire division. We hope to get the word out so more fire departments will begin implementing protocols for the Cyanokit®. I know that Hydrogen Cyanide is out there, and believe it is the culprit for many of the fire deaths in this county. If I can be of any assistance in your departmental process, please feel free to contact me.
In response, Chief Rob Schnepp, Alameda Co. CA Fire Department, opened a Forum to determine how other departments are handling smoke inhalation treatment. His comment follows. Please respond on www.FSCommunity.com. The Coalition can make a difference if the challenges you face are shared with others. Please share