Abstract |
Inadvertent ingestion of sodium nitrite is known to precipitate metheamoglobinaemia. No cases exist, however, of intentional suicide by methaemoglobinaemia following self- poisoning with sodium nitrite. A 76-year-old man collapsed and rapidly developed brady-asystolic cardiac arrest 25 min following self- poisoning with an unknown quantity of crystalline sodium nitrite. On arrival in the ED the patient was asystolic with cardiopulmonary resuscitation in progress. Haemoglobin concentration was 110 g/L, arterial methaemoglobin measured 82.6% and serum lactate 9.6 mmol/L. Antioxidative treatment was undertaken with total 5 mg/kg intravenous methylene blue administered in divided aliquots. Despite prolonged resuscitative efforts the patient died. Resuscitation from methaemoglobinaemia-induced asystole following self- poisoning presents a unique therapeutic challenge. Treatment of methaemoglobinaemia-induced cardiovascular instability and overt cardiopulmonary arrest are discussed.
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Authors | Martyn Harvey, Grant Cave, Giles Chanwai |
Journal | Emergency medicine Australasia : EMA
(Emerg Med Australas)
Vol. 22
Issue 5
Pg. 463-5
(Oct 2010)
ISSN: 1742-6723 [Electronic] Australia |
PMID | 21040485
(Publication Type: Case Reports, Journal Article)
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Copyright | © 2010 The Authors. Emergency Medicine Australasia © 2010 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine. |
Chemical References |
- Carcinogens
- Nitrates
- sodium nitrate
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Topics |
- Aged
- Carcinogens
- Fatal Outcome
- Humans
- Male
- Methemoglobinemia
(chemically induced)
- Nitrates
(poisoning)
- Suicide
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