Massive Sodium Nitrite Overdose: A Case for Prehospital Methylene Blue
Carlos A. Garcia-Galindo, Lesley Pepin, Travis D. Olives, Jon B. Cole, Holly M. Drone, Gregg A. Jones, Nicholas S. Simpson, Ryan T. Fuchs, Aaron E. Robinson
Abstract
Sodium nitrite overdose leads to profound methemoglobinemia and may quickly progress to death. It is an increasingly common method of suicide and is often fatal. Methylene blue is an effective but time-sensitive antidote that has the potential to save lives when administered early. In this case report, we describe a fatal sodium nitrite overdose and the subsequent creation of a prehospital protocol for our large urban Emergency Medical Services system.
Topics & Concepts
MethemoglobinemiaMedicineSodium nitriteAntidoteMethylene blueEmergency medical servicesMedical emergencyEmergency medicineIntensive care medicineAnesthesiaToxicityInternal medicinePhotocatalysisBiochemistryChemistryOrganic chemistryCatalysisMethemoglobinemia and Tumor Lysis SyndromeNeonatal Health and BiochemistryHeme Oxygenase-1 and Carbon Monoxide