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.

Avsnitt(1146)

Podcast 703: Fever in Infants

Podcast 703: Fever in Infants

Contributor: Neil Cella, MD  Educational Pearls: 10% of patients 100.4) have an serious bacterial infection Most of these are UTIs, but also consider pneumonia and meningitis Requires CXR, LP, lab...

10 Aug 20215min

Podcast 702: Paralytic Awareness

Podcast 702: Paralytic Awareness

Contributor: Aaron Lessen, MD Educational Pearls: Known risk factors for being awake and paralyzed in the OR include only receiving IV medications, long-acting paralytics, and no formal monitoring sy...

9 Aug 20212min

Podcast 701: Elevated Blood Pressure Readings

Podcast 701: Elevated Blood Pressure Readings

Contributor: Aaron Lessen, MD Educational Pearls: Recent retrospective cohort study looked at elevated BP readings in the ED and correlation to underlying hypertension Large cohort of over 30,000 pat...

3 Aug 20213min

Podcast 700: Analgesics for Acute Musculoskeletal Pain

Podcast 700: Analgesics for Acute Musculoskeletal Pain

Contributor: Aaron Lessen, MD Educational Pearls: Recent RCT compared pain relief in patients receiving five medications for acute musculoskeletal pain Acetaminophen 1000mg/ibuprofen 400 mg Acetam...

2 Aug 20212min

Podcast 699: Pediatric Fingernail Avulsions

Podcast 699: Pediatric Fingernail Avulsions

Contributor: Aaron Lessen, MD Educational Pearls: Traditionally, fingernails were replaced after avulsion using sutures Sometimes artificial material was placed when the fingernail was not available ...

28 Juli 20213min

Podcast 698: Empathy, Burnout, and Patient Satisfaction

Podcast 698: Empathy, Burnout, and Patient Satisfaction

Contributor: Aaron Lessen, MD Educational Pearls: Survey of EM physicians to self-report empathy and burnout levels and correlated with patient satisfaction scores Patient satisfaction was not affect...

27 Juli 20212min

Podcast 697: Kounis Syndrome

Podcast 697: Kounis Syndrome

Contributor: Aaron Lessen, MD Educational Pearls: Kounis syndrome is an allergic acute coronary syndrome Triggers include medications (antibiotics), insect bites, or other common allergens Believed t...

26 Juli 20213min

Podcast 696: ST Elevation and Differential Diagnoses

Podcast 696: ST Elevation and Differential Diagnoses

Contributor: Peter Bakes, MD Educational Pearls: ST elevation clinical guidelines for myocardial infarction include: 2.5 mm elevation for males 2 mm elevation in males >40 in V2 and V3 1.5 mm elev...

21 Juli 20214min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
rss-ufo-bortom-rimligt-tvivel
det-morka-psyket
rss-vetenskapsradion
medicinvetarna
rss-vetenskapsradion-2
rss-experimentet
sexet
hacka-livet
rss-spraket
dumforklarat
pojkmottagningen
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
halsorevolutionen
paranormalt-med-caroline-giertz