All of the above comments are good points. I agree that cyanide does not directly cause cyanosis. However, cyanide can indirectly cause cyanosis by bradycardia, asystole, and seizures. Right or wrong, I choose not to mention this detail in the article.I agree with that the second dose of hydroxocobalamin is 5 g rather than 5 mg. This was an inadvertent typo.I agree that diuretics are not the treatment of choice for pulmonary edema secondary to choking agents. Rather diuretics have only a limited role in treating phosgene, chlorine, or similar toxicants.1'2 The pulmonary edema is noncardiogenic from this poisoning. Hypovolemia can result from choking agents. Diuretics, especially loop diuretics, would aggravate this hypovolemia and would be contraindicated. Aggressive treatment of hypovolemia can result in inadvertent fluid overload and thus aggravate pulmonary edema. Diuretics may have a role in this situation. My article would have been better if I discussed the limitations and pitfalls of diuretics.
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