new SN fatal case reported in a new scientific article

[aminend]

https://www.tandfonline.com/doi/abs/10.1080/10903127.2020.1838009?journalCode=ipec20

A 17 year female has died with only one tablespoon SN

Abstract
Sodium nitrite is a powerful oxidizing agent that causes hypotension and limits oxygen transport and delivery in the body through the formation of methemoglobin. Clinical manifestations can include cyanosis, hypoxia, altered consciousness, dysrhythmias, and death. The majority of reports on sodium nitrite poisonings have been the result of unintentional exposures. We report a case of an intentional fatal overdose of sodium nitrite. A 17-year-old female reportedly drank approximately one tablespoon of sodium nitrite in a self-harm attempt. The patient was hypotensive and cyanotic upon EMS arrival. The patient decompensated rapidly into a bradycardic arrest during transport despite intubation, push-dose epinephrine, and intravenous fluid resuscitation. In the Emergency Department (ED), she received methylene blue and packed red cells but could not be resuscitated despite a prolonged effort. EMS professionals should consider sodium nitrite toxicity in patients with a suspected overdose who present with a cyanotic appearance, pulse oximetry that remains around 85% despite oxygen, and dark brown blood seen on venipuncture. Early prehospital contact with the Poison Control Center and ED prenotification in poisoned patients is encouraged.

 

[Rn110bg101]

One tablespoon? Is that above or below what's recommended?

 

[aminend]

I think one tablespoon is lower than 10g. Recommended is 20_25g

 

[Rn110bg101]

I think one tablespoon is lower than 10g. Recommended is 20_25g

I imagine she must have taken antiemetics or antacids, no idea how that could have killed otherwise unless she was really lucky

 

[Breadbfra]

Maybe she was very very thin and with a weak body overall. And maybe fasted too.
I don't think she took antiacids and antiemetics, because the report talks about a "self harm attempt", which is comparable to taking 40-50 random pills in from the shelf, I suppose?

 

[Metalhead]

A tablespoon is generally considered to be around 15g.

 

[Silver]

25g is 1.5 tablespoons (US size) so she'll probably have ingested at least 15g, which is what the PPH used to recommend.

 

[Blurred_Reality]

Appear to be a lot more papers on this recently.

 

[AJ95]

I think people underestimate how dangerous SN is, I know Stan recommends 15-25g but the PPH recommends only 10g and says that they estimate a lethal dose could be as low as 3g.

SN is really, really toxic stuff.

 

[Silver]

I think people underestimate how dangerous SN is, I know Stan recommends 15-25g but the PPH recommends only 10g and says that they estimate a lethal dose could be as low as 3g.

SN is really, really toxic stuff.

In the copy of the PPeH I have (March 2020), it says

The estimated lethal dose of SN in adults can be as little as 5gm, although for a reliable death, 25gm is advised (35gm if body weight is >100kg)

 

[Wisdom3_1-9]

People forget that the lethal dose of SN is quite low. The recommended dose as per the regimen(s) is to strike a balance between a very quick poisoning and not immediately throwing up all the SN. You do not need the recommended dose to die. This is why when people "test" small amounts on the SN, they are risking their lives.

Small amounts will kill call you, but may draw out the process. It will take longer for your methemoglobin levels to rise to the point where you would die. This could lead to a longer, more painful death, and a higher potential for being rescued. This individual seemed to achieve her goals regardless.

 

[AJ95]

In the copy of the PPeH I have (March 2020), it says

Oh okay. I saw this in the 2018 version.

 

[StringPuppet]

Sorry if this is a stupid question but could SN ever become illegal?

 

[Rn110bg101]

Sorry if this is a stupid question but could SN ever become illegal?

I doubt it could become illegal HOWEVER they could make it so only professionals can buy some

 

[willitpass]

Sorry if this is a stupid question but could SN ever become illegal?

it's unlikely, that's like a rope or cars becoming illegal just because people use them today. but similar to cars and guns it could become restricted in access. however i don't see that happening anytime soon

 

[Silver]

Sorry if this is a stupid question but could SN ever become illegal?

It's restricted in the UK and some other European countries. In the UK sellers tend to restrict sales to schools and companies and legally they have to record the name of purchaser and the amount purchased. If there are any suspicions about the SN purchase they should inform the police. Hence why UK people order from abroad.

 

[Rn110bg101]

Deaths like these make it look so easy. I hope it'll be this easy when I ctb…

 

[TheEndisNear121200]

I doubt it could become illegal HOWEVER they could make it so only professionals can buy some

This is already the case iny country *sigh*

 

[deleted]

Deaths like these make it look so easy. I hope it'll be this easy when I ctb…

she was about to have a cardiac arrest this is not at all peaceful, but I wonder if at that level she was already passed out

 

[Aap]

She was long unconscious. They don't intubate people who are conscious.

 

[MiseryLovesMyCompany]

she was about to have a cardiac arrest this is not at all peaceful, but I wonder if at that level she was already passed out

I mean if you die you 100% get cardiac arrest. I'm pretty sure she was unconscious by that time.

 

[Lordsudbury]

She was 17 she could have been tiny.

All the big fancy doctor words in the Abstract make it seem so painful and crazy

 

[justpeachy]

I think people underestimate how dangerous SN is, I know Stan recommends 15-25g but the PPH recommends only 10g and says that they estimate a lethal dose could be as low as 3g.

SN is really, really toxic stuff.

Yes! There's been a couple cases (albeit it's rare) where people died from just a couple grams so 10-15g especially if she's small, drank it all at once, etc is easily an obtainable death. Also it sounds as if she was just trying to self harm not die which is sad that she underestimated just how toxic SN really is and in the amount she consumed. So young.

 

[I screwed up]

Wish I was in her place ... Bloody hell I just can't muster the courage to ctb ...