Sodium Thiosulphate
Liverpool Hospital Emergency Department
Indications:
- Cyanide Toxicity (empirical use)
Formulation:
- 25g/100mL vial
Dosage and Administration:
- Mild cyanide poisoning as an alternative to hydroxocobalamin
- 12.5g (50ml of 25% solution) IV over 10 minutes
- Paediatrics 400mg/kg to a maximum of 12.5g
- Repeat after 30-60 mins if no improvement
- Moderate to severe cyanide poisoning give WITH hydroxocobalamin
- 12.5g (50ml of 25% solution) over 10 minutes
- (paediatrics 400mg/kg up to max 12.5g)
- Repeat after 30-60 minutes if there is no clinical improvement after the second dose of hydroxocobalamin
Side effects:
- Nausea and vomiting
- Hypotension
- Headache
- Abdominal pain
- Disorientation
Pit Falls:
- Ensure cyanide level taken prior to administration