Histotoxic hypoxia is the inability of cells to take up or utilize oxygen from the bloodstream, despite physiologically normal delivery of oxygen to such cells. This occurs in a few circumstances, but it is most concerning to me as a firefighter these days since so many synthetic materials found in structures off gas cyanide when burned. The cyanide ion halts cellular respiration by inhibiting an enzyme in the mitochondria called cytochrome c oxidase, the last enzyme in the respiratory electron transport chain.
And this is probably the cause of more firefighter deaths than we know about. There is research out there that suggests that Line of Duty Deaths (LODD) attributed to heart attacks, medical emergencies, or worst of all, the firefighters that are though of as having "panicked inside the fire", may have actually suffered from acute cyanide poisoning.
Acute cyanide poisoning can cause confusion and delirium that is mistaken for "panic", and lethal arrhythmias that are mistaken for heart attacks. Definitive treatment is very specific to antidote kits, but most health care providers would not consider it as a differential. Not their fault, the information is just not out there!
Thank God there are some good people doing important research in bringing this information to light. Until this information is more defined, and the rest of the community realizes this is a problem, we in the fire service need to look out for our selves, get informed, and share the information when needed.
We need to do better in understanding the "new beast" we fight. This is not the same fire as our forefathers fought. Everything is different. The construction, the material, the smoke... it is all different. Let's study it, understand it, and teach each other what to do about it. Enough of us have died! It's our worst tradition... dying young.
How about it?
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