Uworld said that in carboxy hemoglobin the pulse oximetry does not differentiate it from oxyhemoglobin - so it is not reliable and we need to do an ABG (I hope I am correct about this).
For methemoglobin, however, they say that pulse oximeter shows readings around 85%- what does this imply??
Thanks in advance!
Question inspired while studying but realizing that textbooks really don't care much about giving you the full picture and just like tossing random words around.
Hey ya'll,
Sodium nitrite poisoning as a suicide mechanism was featured on the front page of the NYTimes today. There are apparently online suicide forums that are currently advocating this method. I figured it might be good to get a discussion going.
https://www.nytimes.com/interactive/2021/12/09/us/where-the-despairing-log-on.html
EDIT (I feel stupid for not including this earlier): If you are having thoughts of suicide, in the United States call the National Suicide Prevention Lifeline at 800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources. Go here for resources outside the United States.
The fucked-uped-ness of these websites aside, I realized that I don't know much about treatment for sodium nitrite poisoning and I'm guessing at least one other person here isn't on the up-and-up so here's a brief EMS-relevant summary (tox docs feel free to pitch in):
The following information is from Neth et al. 2021 (full citation below), listed in PubMed here: https://pubmed.ncbi.nlm.nih.gov/33074043/
Obligatory disclaimer: I AM NOT A PHYSICIAN. THIS POST IS FOR INFORMATIONAL PURPOSES AND TO GENERATE DISCUSSION ON THIS FORUM. THIS SHOULD NOT BE CONSIDERED MEDICAL ADVICE, ALWAYS CONSULT WITH YOUR MEDICAL DIRECTION AND/OR PROTOCOLS FOR GUIDANCE REGARDING PATIENT CARE
Key points:
- Sodium nitrite is commonly used to preserve meats, color stuff, and kill microbes. It can be used used to treat cyanide toxicity, but it can also cause harm when not indicated or overdosed
- Sodium nitrite poisoning is most commonly reported as accidental, but has been reported as suicide method (see NYTimes article)
- Patients with sodium nitrite poisoning present with cyanosis, hypoxia, AMS, dysrhythmias and can quickly proceed to cardiac arrest
- Sodium nitrite converts the hemoglobin in your blood to methemoglobin and can therefore result in methemoglobinemia (https://www.sciencedirect.com/topics/medicine-and-dentistry/methemoglobinemia)(https://www.youtube.com/watch?v=ihr5RNzKu6Q)
- If you don't recall, normal hemoglobin carries oxygen through your body
Do your worst!
It really does, I swear!
For context I'm a Refuse Driver (Garbage man) & today I was on food waste. After I'd tipped I was checking the wagon for any defects when I spotted a lone pea balanced on the lifts.
I said "hey look, an escaPEA"
No one near me but it didn't half make me laugh for a good hour or so!
Edit: I can't believe how much this has blown up. Thank you everyone I've had a blast reading through the replies 😂
They’re on standbi
Buenosdillas
Pilot on me!!
Dad jokes are supposed to be jokes you can tell a kid and they will understand it and find it funny.
This sub is mostly just NSFW puns now.
If it needs a NSFW tag it's not a dad joke. There should just be a NSFW puns subreddit for that.
Edit* I'm not replying any longer and turning off notifications but to all those that say "no one cares", there sure are a lot of you arguing about it. Maybe I'm wrong but you people don't need to be rude about it. If you really don't care, don't comment.
When I got home, they were still there.
What did 0 say to 8 ?
" Nice Belt "
So What did 3 say to 8 ?
" Hey, you two stop making out "
I won't be doing that today!
You take away their little brooms
This morning, my 4 year old daughter.
Daughter: I'm hungry
Me: nerves building, smile widening
Me: Hi hungry, I'm dad.
She had no idea what was going on but I finally did it.
Thank you all for listening.
There hasn't been a post all year!
It’s pronounced “Noel.”
After all his first name is No-vac
What, then, is Chinese rap?
Edit:
Notable mentions from the comments:
-
Spanish/Swedish/Swiss/Serbian hits
-
French/Finnish art
-
Country/Canadian rap
-
Chinese/Country/Canadian rock
-
Turkish/Tunisian/Taiwanese rap
There hasn't been a single post this year!
(Happy 2022 from New Zealand)
Nothing, it just waved
Bob
So that I could frequently say, "I am going to walk 5 miles now."
Edit: My most popular post on Reddit! 😀 Thank you for the awards.
