Definitive treatment

Gastric lavage, if indicated, should be delayed until after the administration of antidotes, unless the patient is asymptomatic.

If the diagnosis is certain:

• 100 % oxygen
• dicobalt edetate 600 mg i.v. over 1 minute, followed by a further 300 mg if the patient does not recover within one minute
• if no response, 10 ml 3% solution of sodium nitrite i.v. over 3-4 minutes, followed by 25 ml 50% sodium thiosulphate over 10 minutes
• cardiorespiratory support

If the diagnosis is uncertain:

• as above but omit the dicobalt edetate, and use 50 ml of 25% sodium thiosulphate