Emergency Medical Minute10 Jan 2022

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 recreational drug
N2O binds and inactivate B12 in the body, therefore decreasing usable supply
Lack of B12, which is essential for myelinating nerves, can lead to subacute combined degeneration of the spinal cord
Presentation may include paresthesias, ataxia, gait changes, or bilateral lower extremity motor weakness
B12 can be normal on labs, as the B12 is present but inactivated
Treatment is daily B12 injections and oral supplementation

References

Stockton L, Simonsen C, Seago S. Nitrous oxide-induced vitamin B12 deficiency. Proc (Bayl Univ Med Cent). 2017;30(2):171-172. doi:10.1080/08998280.2017.11929571

Samia AM, Nenow J, Price D. Subacute Combined Degeneration Secondary to Nitrous Oxide Abuse: Quantification of Use With Patient Follow-up. Cureus. 2020;12(10):e11041. Published 2020 Oct 19. doi:10.7759/cureus.11041

Edigin E, Ajiboye O, Nathani A. Nitrous Oxide-induced B12 Deficiency Presenting With Myeloneuropathy. Cureus. 2019;11(8):e5331. Published 2019 Aug 6. doi:10.7759/cureus.5331

*Image obtained from Wikimedia author Hansmuller and licensed under Creative Commons Attribution-Share Alike 4.0 International license.

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account.

Donate to EMM today!

Denne episoden er hentet fra en åpen RSS-feed og er ikke publisert av Podme. Den kan derfor inneholde annonser.

Episoder(1170)

Podcast 1015: Calcium in Hyperkalemia

Contributor: Meghan Hurley, MD Educational Pearls: What is hyperkalemia? Hyperkalemia is when the measured blood level of potassium reaches above 5.2 - 5.5 mEq/L (normal 3.5 - 5.2 mEq/L). What ar...

3 Aug 7min

Podcast 1014: Eating and Drinking on Shift

Contributor; Aaron Lessen, MD Educational Pearls: A 2026 survey asked Canadian emergency medicine (EM) physicians about their eating and drinking habits while on shift. Among 527 respondents, 35%...

27 Jul 2min

Podcast 1013: Thoracotomy Indications

Contributor; Taylor Lynch, MD Educational Pearls: Thoracotomy Thoracotomy is used in traumatic cardiac arrest to replace conventional CPR with direct access to the chest. Goals include identif...

20 Jul 3min

Podcast 1012: Meth Sedation

Contributor: Aaron Lessen, MD Educational Pearls: Agitated patients who are intoxicated with methamphetamine pose a unique challenge when selecting a sedative to counter their symptoms. Is there ...

13 Jul 1min

Podcast 1011: Creepy Crawlies

Contributor: Meghan Hurley, MD Educational Pearls: What animal is the most lethal to humans? Depending on how we define lethal, and animal, this answer is actually not straight forward. Globall...

6 Jul 7min

Podcast 1010: First Pass Intubation Success

Contributor: Travis Barlock, MD Educational Pearls: First-pass success is critical to limit complications from apnea, hypoxia, and airway trauma. Complication rate for patients intubated on the f...

29 Jun 3min

On the Streets- Zero to Rodeo

Dan Orbidan, OMS-II and Dr. Travis Barlock, MD discuss a real out of hospital call. This episode covers the implications of a pharmacologically abnormal patient presentation and the pre and post hospi...

22 Jun 35min