Smoke Inhalation & Cyanide: Know the Facts!

Take a few minutes to watch our quick, informative video on the dangers of fire smoke and cyanide poisoning and what you can do to protect yourself and your loved ones in the event of a life-threatening emergency.

In every community lies the potential for unforeseen hazards, and smoke inahalation and cyanide poisoning are among the most serious.  As experts in Emergency Medicine, BTG Pharmaceuticals is committed to empowering the public as well as healthcare professionals with the knowledge and resources to prevent and manage these health hazards.

Take a few minutes to watch our quick, informative video on the dangers of fire smoke and cyanide poisoning and what you can do to protect yourself and your loved ones in the event of a life-threatening emergency.

Frequently Asked Questions
Dangers of Cyanide Poisoning from Smoke Inhalation

Is life-threatening cyanide poisoning caused by smoke inhalation?

Yes. Exposure to smoke, especially from enclosed space fires, poses a significant risk of life-threatening cyanide poisoning.1 Combustion of common household and business items releases toxic levels of cyanide, making smoke inhalation the most common cause of acute cyanide poisoning.1,4

When should cyanide poisoning be suspected in smoke inhalation patients?

Exposure to fire or smoke in an enclosed area1

Soot around the mouth, nose, or back of the mouth1

Altered mental status (e.g., confusion, disorientation)1

What are common signs and symptoms of cyanide poisoning?

  • Headache1
  • Shortness of breath and chest tightness1
  • Nausea and vomiting1
  • Anxiety and agitation2,5
  • Confusion5
  • Bradycardia (slow heart rate) or tachycardia (fast heart rate)2
  • Hypertension (high blood pressure) or hypotension (low blood pressure)2
  • Fatigue5
  • Seizures and coma2,5
  • Cardiac arrest2

Differentiating Between Carbon Monoxide Poisoning and Cyanide Poisoning: The “Toxic Twins”

It can be challenging to distinguish between carbon monoxide poisoning and cyanide poisoning, often referred to as the “toxic twins.” Both cyanide and carbon monoxide are released during fires, and their signs and symptoms can overlap, causing significant harm together. These dangers may contribute to heart attacks at the time of the fire and long-term health issues, including cancer. Some of the signs and symptoms shared by both1,2,4,5,6,7,8 include 

  • Headache
  • Nausea
  • Vomiting
  • Seizures
  • Tachycardia (fast heart rate)
  • Dizziness
  • Shortness of breath
  • Confusion
  • Altered mental status

What to Do If Cyanide Poisoning Is Suspected

Cyanide poisoning prevents the cells in the body from using oxygen, particularly in the brain and heart, and can be life-threatening in a matter of minutes.1,4,11

Immediate Action Can Save Lives

If you suspect cyanide poisoning, taking immediate action is crucial to increase the chances of survival. Follow these steps:

  • Remove the Patient from the Source of Exposure:
    • Move the affected person away from the source of smoke or fire immediately. This helps reduce further exposure to cyanide.
  • Assess and Stabilize the Patient:
    • Conduct an immediate assessment of the patient’s condition and take measures to stabilize them. This may include providing basic life support as needed.

Field Treatment with Cyanide Antidote:

Field treatment with a cyanide toxicity antidote is of critical importance and should be considered if available. Follow your state, local, or department protocols for administering antidotes. The seriousness of cyanide poisoning demands an immediate and specific response. Every second after exposure is vital, and steps should be taken promptly to increase the chances of survival.

Is There an Antidote for Known or Suspected Cyanide Poisoning?

Yes. Healthcare providers, including first responders, have access to an antidote for known or suspected cyanide poisoning. For expert advice, contact a regional poison control center by calling 1-800-222-1222.

Remember, the timely administration of the antidote can be a critical factor in the patient’s recovery. It is essential to follow established protocols and seek professional guidance in managing cases of cyanide poisoning.


1. Eckstein M, et al. Prehosp Disaster Med. 2006;21(2):s49-s55.

2. Lawson-Smith P, et al. Scand J Trauma Resusc Emerg Med. 2011;19:14.

3. Tabian D, et al. Toxics. 2021; 9(2):36.

4. Guidotti T. Prehosp Disaster Med. 2005;21(2):s40-s48.

5. Stevens J, El-Shammaa E. Carbon monoxide and cyanide poisoning in smoke inhalation victims. Relias Media website. Accessed August 3, 2023.

6. Culnan DM, et al. Ann Plast Surg. 2018;(3 Suppl 2):S106-S112.

7. Gracia R et al. Pharmacotherapy. 2004;24(10):1358-1365.

8. Understanding the Toxic Twins: HCN and CO. Drägerwerk AG & Co. Accessed March 10, 2023. Library/Content/toxic-twin-lt-8177-en-gb.pdf

9. Chenoweth JA, et al. Crit Care Clin. 2021;37(3):657-672. 10. Rose JJ, et al. Am J Respir Crit Care Med. 2017;195(5):596-606.

11. Anseeuw K, et al. Eur J Emerg Med. 2013;20(1):2-9.

12. Baskin SI, Brewer TG. Chapter 10: Cyanide poisoning. In: Medical Aspects of Chemical and Biological Warfare. US Army Medical Research Institute of Chemical Defense. Published 2008. Accessed August 9, 2023. https://www.hsdl. org/?view&did=3241

13. Chemical Emergencies. Cyanide exposure, decontamination, treatment. Centers for Disease Control and Prevention website. Accessed August 9, 2023.

14. National Association of State EMS Officials. National Model EMS Clinical Guidelines: Version 2.2. National Association of State EMS Officials; 2019.

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