SNHD Paramedic Protocols Practice Test

How is hydroxocobalamin administered in smoke inhalation treatment?

5 g IV over 15 minutes 5 g IM 500 mg IV over 60 minutes 1 g IV bolus

Correct Answer:

5 g IV over 15 minutes

Explanation:

When cyanide poisoning from smoke inhalation is suspected, hydroxocobalamin is given IV to bind cyanide quickly. The standard emergent dose is 5 g administered over about 15 minutes, providing rapid cyanide sequestration so tissues can resume oxygen use. Intravenous delivery ensures fast onset; administering by intramuscular route would delay absorption and delay treatment. The other dosing options are not appropriate because they are either far too small or not delivered in a way that achieves rapid, sufficient cyanide binding. A 5 g IV dose over 15 minutes is the widely accepted approach, with a second dose sometimes considered per local protocols if needed.

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