
aminend
Warlock
- May 24, 2020
- 746
This report describes a 16-year old girl (case 108), who exhibited lack of efficacy while being treated with methylthioninium
chloride for acute sodium nitrite poisoning. The girl intentionally ingested sodium nitrite powder (purchased online). An emergency
medical services (EMS) initially found her responsive, but she became unresponsive and cyanotic enroute to the emergency
department (ED). She was then intubated and ventilated. She became bradycardic, and went into pulseless electrical activity arrest,
and was resuscitated with CPR, epinephrine and sodium bicarbonate. Additionally, she received IV methylthioninium chloride
[methylene blue] 1 mg/kg over 1 hour and a second dose 30 minutes later. However, her methemoglobin (MetHgb) remained
elevated despite treatment. She was transfused blood. She was found to have no cardiac activity and asystole. She died 2 h after ED
arrival. As per autopsy findings, she was died due to sodium nitrite poisoning
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chloride for acute sodium nitrite poisoning. The girl intentionally ingested sodium nitrite powder (purchased online). An emergency
medical services (EMS) initially found her responsive, but she became unresponsive and cyanotic enroute to the emergency
department (ED). She was then intubated and ventilated. She became bradycardic, and went into pulseless electrical activity arrest,
and was resuscitated with CPR, epinephrine and sodium bicarbonate. Additionally, she received IV methylthioninium chloride
[methylene blue] 1 mg/kg over 1 hour and a second dose 30 minutes later. However, her methemoglobin (MetHgb) remained
elevated despite treatment. She was transfused blood. She was found to have no cardiac activity and asystole. She died 2 h after ED
arrival. As per autopsy findings, she was died due to sodium nitrite poisoning
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