The importance of cyanide toxicity as a component of inhalational injury in patients with
burns is increasingly being recognised, and its prompt recognition and management is vital
for optimising burns survival. The evidence base for the use of cyanide antidotes is limited
by a lack of randomised controlled trials in humans, and in addition consideration must be
given to the concomitant pathophysiological processes in patients with burns when interpreting
the literature. We present a literature review of the evidence base for cyanide
antidotes with interpretation in the context of patients with burns. We conclude that
hydroxycobalamin should be utilised as the first-line antidote of choice in patients with
burns with inhalational injury where features consistent with cyanide toxicity are present