Fig. 5

Appropriateness of diagnostic and management strategies for burn inhalation injury associated systemic toxicity. For each statement, median scores were calculated. Statements with a median score of ≤ 3 being classed inappropriate (red background), > 3 and < 7 uncertain (amber background) and ≥ 7 appropriate (green background). Clinical suspicion of hydrogen cyanide toxicity was defined as low (normal blood lactate and the absence of potentially suspicious features), moderate (moderate lactatemia below 8 mmol/L and few potentially suspicious features) and high (hyperlactataemia ≥ 8 mmol/L and potentially suspicious features including anion gap lactic metabolic acidosis, altered consciousness, unexplained cardiac dysfunction). High serum lactate was defined as ≥ 8 mmol/L. Disagreement was not present for any statements. BII, burn inhalation injury. Panellists n = 15. *Until a higher clinical suspicion or laboratory confirmation is available