UMEM Educational Pearls


Patient was found in a house fire and was given a certain medication in the Emergency Room. The patient’s urine turned this color (red), what’s the diagnosis?


Hydroxocobalamin (i.e., Cyanokit)

Cyanide toxicity

  • Occurs secondary to combustion of natural and synthetic products producing cyanide
  • Patients recovered from fires should have a lactate level drawn; levels greater than 10 are concerning for cyanide toxicity.  
  • The Cyanokit contains hydroxocobalamin, a form of vitamin B12 that is used as the antidote.
  • Hydroxocobalmin has many side-effects including self-limited hypertension, flushing of the skin, and red urine for up to 14 days.  
  • See a previous UMEM post by Dr. Bryan Hayes for more information 


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