Hydroxocobalamin for Cyanide poisoning
Adult dosing has a median of 5000 mg across 115 published protocols, with the middle half between 5000 and 5000.
Includes 3 agencies outside the US.
Doses far off from what other protocols give are likely misreads, so they are left out until checked. How that works.
Adultmg
| min | p25 | median | p75 | max |
|---|---|---|---|---|
| 5000 | 5000 | 5000 | 5000 | 5000 |
Values in mg. One value per source (that source's median), so a document listing a medication five times still gets one vote.
Routes
- IV/IO 54%
- IV 46%
United States EMS Protocol Census, n=115 protocols from 97 named agencies / 41 states, updated Oct 2026
Pediatric, weight-basedmg/kg
| min | p25 | median | p75 | max |
|---|---|---|---|---|
| 70 | 70 | 70 | 70 | 100 |
Values in mg/kg. One value per source (that source's median), so a document listing a medication five times still gets one vote.
Routes
- IV/IO 61%
- IV 39%
United States EMS Protocol Census, n=101 protocols from 86 named agencies / 37 states, updated Oct 2026
Adult, weight-basedmg/kg
| min | p25 | median | p75 | max |
|---|---|---|---|---|
| 70 | 70 | 70 | 70 | 70 |
Values in mg/kg. One value per source (that source's median), so a document listing a medication five times still gets one vote.
Routes
- IV/IO 83%
- IV 17%
United States EMS Protocol Census, n=12 protocols from 12 named agencies / 6 states, updated Oct 2026
Named agencies with a page107
Agencies whose protocols are a public record are named here. Their own doses are on their own pages; this list carries no values.
- Academy of Medicine of Cincinnati
- Ada County-City Emergency Services System
- Alabama Department of Public Health Office of Emergency Medical Services
- Ambulance Victoria
- Arizona Department of Health Services
- Arlington EMS System
- Ashwaubenon Public Safety, Howard Fire Rescue, & De Pere Fire Rescue
- Aurora Fire Rescue
- BC Emergency Health Services
- Berrien County Medical Control Authority
- BEST EMS
- Bexar County ESD 4 Fire Rescue
- Boulder County Protocol Committee
- Brunswick County EMS
- Cabarrus County EMS
- Campbell County Emergency Medical Service
- Central Arizona Regional EMS
- Chelan/Douglas/Okanogan/Grant County
- City of Austin / Austin-Travis County EMS System
- Clark County EMS System
- Confederated Tribes of Grand Ronde Department of Emergency Services
- County of San Diego Emergency Medical Services
- Cowlitz County EMS Council
- Craven, Jones, Pamlico Counties EMS
- Dallas Fire-Rescue
- Dane County EMS System
- Davidson County Emergency Services
- Daviess County EMS
- DC Fire and EMS
- Denver Health Paramedic Division
- Department of Health Services, County of Los Angeles
- East Baton Rouge Parish Department of Emergency Medical Services
- Escambia County Emergency Medical Services
- Fairfax County Fire and Rescue Department
- Fern Creek Fire and Emergency Medical Services
- Fort Lauderdale Fire Rescue
- Fort Worth Regional EMS System
- Grant County
- Greater Elgin Area EMS System
- Hays County ESD 9 EMS
- Houston Fire Department
- Illinois Region VIII Emergency Medical Services
- Kentucky Board of Emergency Medical Services
- Kosciusko County Paramedics
- Lake County Emergency Medical System
- Lake Emergency Medical System
- Lane County Medical Control Board
- Maine Emergency Medical Services
- County of Marin EMS
- Maryland Institute for Emergency Medical Services Systems
- Massachusetts Office of Emergency Medical Services
- McKinney Fire Department
- MEP (Medical Emergency Partnership) in partnership with SSM Health
- MetroCare Services and Abilene Fire Department
- Michigan Department of Health and Human Services
- Michigan Department of Health and Human Services (MDHHS) / Midland Gladwin MCA
- Michigan Department of Health and Human Services (MDHHS) / West Michigan Regional MCC
- Ministry of Health, Emergency Health Regulatory and Accountability Branch
- Montana Board of Medical Examiners
- Montgomery County Hospital District
- Mountain West Ambulance
- Muskegon County
- Nebraska Medicine Division of Prehospital and Emergency Medical Services
- Nevada EMS Program
- New Hampshire Bureau of Emergency Medical Services
- New Jersey Department of Health
- New Mexico EMS Bureau
- North Carolina Office of Emergency Medical Services (NC OEMS)
- Northeast Ohio Regional EMS Protocol Committee
- Northeastern Montana Stat Air Ambulance Cooperative
- Northwest Community EMS System
- Ocala/Marion County/The Villages Public Safety EMS
- OCEMS
- Office of the EMS Medical Director for Kansas City, Missouri
- Oklahoma State Department of Health
- Palm Beach Gardens Fire Rescue
- Pend Oreille County Emergency Medical Services
- Peninsulas EMS Council, Inc.
- Platte Valley Ambulance Service
- Rappahannock EMS Council
- Region 4 EMS
- Region X EMS
- Regional Emergency Medical Advisory Committee of New York City
- REMSA
- REMSA Sioux Falls
- Rhode Island Department of Health – Center for Emergency Medical Services
- Rowan County Emergency Services EMS Division
- Salem Fire Department
- South Carolina Department of Public Health (DPH) Division of EMS
- Southern Fox Valley EMS System
- Spokane County EMS
- St. Johns County Fire Rescue
- Stanly County EMS
- State of Nebraska
- Tennessee Emergency Medical Services
- The Williamson County EMS System
- Three Rivers Ambulance Authority & Fort Wayne Fire Department
- Thurston County Medic One
- Tidewater Emergency Medical Services Council, Inc.
- Tippecanoe Emergency Ambulance Service
- Tri-County Emergency Medical Control Authority
- Utah Department of Public Safety, Bureau of Emergency Medical Services
- UTSW/Parkland BioTel EMS System
- Vermont Department of Health
- Wake County EMS System
- West Virginia Department of Health, Office of Emergency Medical Services
- Wilson County ESD #4