Inhaled toxins more rapid than ingested.Affected by dose, route, formulation and exposure pattern.They found 50% ROSC in fire victims in full arrest when hydroxycobalamin was administered. Full arrest without full body burns incompatible with life.Paris Fire Brigade protocol recommend hydroxocobalamin administration patients who have had known smoke inhalation in an enclosed space with any of the following: Causes switch from aerobic to anaerobic metabolism despite adequate O2.Binds to cytochrome oxidase in mitochondria leads to cessation of electron transport.
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