Massive Sodium Nitrite Overdose: A Case for Prehospital Methylene Blue

Abstract

Sodium nitrite overdose leads to profound methemoglobinemia and may quickly progress to death. It is an increasingly common method of suicide and is often fatal. Methylene blue is an effective but time-sensitive antidote that has the potential to save lives when administered early. In this case report, we describe a fatal sodium nitrite overdose and the subsequent creation of a prehospital protocol for our large urban Emergency Medical Services system.

Acknowledgments

We would like to thank the Minnesota Poison Control System for their outstanding collaboration and support.

Declaration of Generative AI in Scientific Writing

The authors did not use a generative artificial intelligence (AI) tool or service to assist with preparation or editing of this work. The author(s) take full responsibility for the content of this publication.

Disclosure Statement

None of the authors have conflicts of interest to report.