Podcast #322: Methemoglobinemia

Podcast #322: Methemoglobinemia

Author: Nick Hatch, M.D.

Educational Pearls:

  • Methemoglobinemia is when the iron in hemoglobin is in the Fe3+ (ferric) state rather than the normal Fe2+ (ferrous) state. Methemoglobin cannot release oxygen at the tissues.
  • Symptoms include cyanosis, headache, tachycardia, dyspnea, and lethargy.
  • Suspect in setting of hypoxia that does not improve with oxygenation, and clinical cyanosis with a normal PaO2 on ABG.
  • Treatment is methylene blue which reduces the iron back to the ferrous state.
  • Causes can be Dapsone, Lidocaine, Benzocaine.

References:

Agarwal N, Nagel RL, Prchal JT. Dyshemoglobinemias. In: Disorders of Hemoglobin: Genetics, Pathophysiology, and Clinical Management, 2nd ed, Steinberg M (Ed), 2009. P.607

Cortazzo JA, Lichtman AD. (2014). Methemoglobinemia: a review and recommendations for management. Journal of Cardiothoracic and Vascular Anesthesia. 28:1043.

Darling R, Roughton F. (1942). The effect of methemoglobin on the equilibrium between oxygen and hemoglobin. American Journal of Physiology. 137:56.

Episoder(1146)

Podcast 747: Food Impaction

Podcast 747: Food Impaction

Contributor: Ricky Dhaliwal, MD Educational Pearls: Esophageal food impaction can be managed in the ED prior to calling GI for endoscopy Coca-cola, glucagon, benzodiazepines, calcium channel blockers...

17 Jan 20223min

Podcast 746: Elderly Head Trauma on Anticoagulation

Podcast 746: Elderly Head Trauma on Anticoagulation

Contributor: Aaron Lessen, MD Educational Pearls: Biggest study to date examined new protocol for repeat head CT in anticoagulated elderly patients with head trauma and an initial negative head CT ...

11 Jan 20223min

Podcast 745: Nitrous-Induced B12 Deficiency

Podcast 745: Nitrous-Induced B12 Deficiency

Contributor: Alicia Oberle, MD Educational Pearls: Nitrous oxide (N2O) can cause a vitamin B12 deficiency in patients after regular use N2O is used in procedural sedation but also as a popular recrea...

10 Jan 20222min

Podcast 744: Glucagon for Beta Blocker Toxicity

Podcast 744: Glucagon for Beta Blocker Toxicity

Educational Pearls: Glucagon can be used to treat hypoglycemia and esophageal foreign body, but it can also be used in beta-blocker toxicity to bypass cardiac beta-blockade The superior option for tr...

4 Jan 20222min

Podcast 743: Rust Rings

Podcast 743: Rust Rings

Contributor: Jared Scott, MD Educational Pearls: A rust ring can occur after a metallic foreign body is left in the eye for a prolonged period of time Issues occur when the rust ring is left as it ca...

3 Jan 20225min

Podcast 742: Pulse Check During CPR

Podcast 742: Pulse Check During CPR

Contributor: Aaron Lessen, MD Educational Pearls: Pulse checks are necessary during CPR to check for return of spontaneous circulation (ROSC) Previous studies have shown that assessing ROSC with palp...

29 Des 20213min

Podcast 741: Calcium for Cardiac Arrest

Podcast 741: Calcium for Cardiac Arrest

Contributor: Aaron Lessen, MD Educational Pearls: Study of nearly 400 patients evaluating giving calcium during cardiac arrest with the endpoint as return of spontaneous circulation (ROSC) Compared g...

28 Des 20212min

Podcast 740: Placenta Previa

Podcast 740: Placenta Previa

Contributor: Peter Bakes, MD Educational Pearls: High concern causes of third trimester vaginal bleeding include placenta previa, placental abruption, or vasa previa In placenta previa, the placenta ...

21 Des 20213min

Populært innen Vitenskap

fastlegen
rekommandert
jss
tingenes-tilstand
rss-rekommandert
villmarksliv
liberal-halvtime
sinnsyn
forskningno
rss-paradigmepodden
fjellsportpodden
nevropodden
rss-nysgjerrige-norge
diagnose
vett-og-vitenskap-med-gaute-einevoll
abid-nadia-skyld-og-skam
tidlose-historier
dekodet-2
smart-forklart
hva-er-greia-med