Methylene blue by intraosseous infusion for methemoglobinemia

M. I. Herman, Peter Chyka, A. Y. Butler, S. E. Rieger

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Intraosseous administration of methylene blue may be an emergency alternative to intravascular administration. A 6-week-old female infant [3 kg) presented to the emergency department after a 1-week illness and appeared cyanotic and listless. Oxygen saturation by oximetry was 86% while the patient was receiving oxygen. Vital signs were blood pressure, 107/80 mm Hg; pulse, 190; respirations, 47; temperature, 39.0°C. A metabolic acidosis and a methemoglobin level of 29.3% were present. After several unsuccessful attempts to establish intravenous access, an intra- osseous needle was placed in the infant's left tibia. Methylene blue, 1 mg/kg, normal saline solution, and sodium bicarbonate were given intraosseously. The patient's oxygen saturation rose to 98% to 100%, and her cyanosis improved. Three hours later, her methemoglobin level was 8.2%. The child recovered uneventfully and was sent home after 3 days. Intraosseous administration of standard intravenous doses of methylene blue rapidly terminated the effects of acquired methemoglobinemia.

Original languageEnglish (US)
Pages (from-to)111-113
Number of pages3
JournalAnnals of Emergency Medicine
Volume33
Issue number1
DOIs
StatePublished - Jan 1 1999
Externally publishedYes

Fingerprint

Intraosseous Infusions
Methemoglobinemia
Methylene Blue
Methemoglobin
Oxygen
Cyanosis
Sodium Bicarbonate
Oximetry
Vital Signs
Acidosis
Tibia
Sodium Chloride
Intravenous Administration
Needles
Pulse
Hospital Emergency Service
Respiration
Emergencies
Blood Pressure
Temperature

All Science Journal Classification (ASJC) codes

  • Emergency Medicine

Cite this

Methylene blue by intraosseous infusion for methemoglobinemia. / Herman, M. I.; Chyka, Peter; Butler, A. Y.; Rieger, S. E.

In: Annals of Emergency Medicine, Vol. 33, No. 1, 01.01.1999, p. 111-113.

Research output: Contribution to journalArticle

Herman, M. I. ; Chyka, Peter ; Butler, A. Y. ; Rieger, S. E. / Methylene blue by intraosseous infusion for methemoglobinemia. In: Annals of Emergency Medicine. 1999 ; Vol. 33, No. 1. pp. 111-113.
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