EM@3AM - emDocs - November 21, 2020 - By Taylor Guinn
Reviewed by: Alex Koyfman, Brit Long & Cynthia Santos
"Pearls:
- While rare, it is important to be aware of causative factors for methemoglobinemia, with topical anesthetics being the most common precipitant in the ED.
- Treat with methylene blue if a patient is symptomatic or has a methemoglobin level >25%.
- Methylene blue dose is 1-2 mg/kg given over a 5 minute slow push.
- Improvement and disposition should be dictated by clinical examination, not repeat methemoglobin testing."