What if SN fails and the hospital doesnt have MB?

[Kta1994]

I live in a small town in brazil, i dont think the hospital here has methylene blue, if i fail to ctb (vomit, not enough dose, being rescued) what will happen if i survive?

 

[Scacie]

Methylene blue is an antidote, purely to revert methemoglobin to haemoglobin (i believe). If you failed to CTB, and vomited it out, I don't think you will have any permanent damage? Since you technically never received a lethal dose

 

[Tartuffe]

They'll probably put you in an induced coma and attempt to revive you when they can get anything necessary

 

[freelifexit]

There are no negative info about consequences from people who failed SN on this forum, except two cases who got problems with kidneys.

But there is info from this Russian article about SN poisoning consequences (first two paragraphs on page 6).

"In severe cases of intoxication due to degenerative changes in erythrocytes and a decrease in their resistance, hemolysis and secondary hemolytic anemia occur (on the 3-5th day after poisoning). In this case, hemoglobinuria, kidney damage (nephropathy with varying degrees of acute renal failure) and liver damage (toxic hepatopathy) can be observed. Severe acute vascular insufficiency (nitrite shock), coma, pulmonary edema may develop. The clinical picture of poisoning is highly variable. In some cases, changes in the respiratory organs come to the fore, in others - in the cardiovascular and central nervous systems, in others - in the blood system."

Also there are no comments about brain damage on this forum from people who failed SN.

But there are several articles which say that brain damage is possible.

From this article (Page 2, Discussion, 2nd paragraph): "Nitrite is also a potent vasodilator and can
cause coronary ischemia and stroke as a result of hypotension, tachycardia, and hypoxia."

Also article about survived case with brain damage: "Delayed post-hypoxic leukoencephalopathy (DPHL) is a demyelinating syndrome that occurs days to weeks after the brain has recovered from a coma. It is caused by the period of hypoxia and is characterized by mental disorders, extrapyramidal system symptoms, and motor changes. Common causes include cardiogenic shock, severe anemia, massive blood loss, and poisoning. There are only a few reports of DPHL due to nitrite poisoning in literature.

Most patients usually recover completely. However, DPHL can easily induce long-term neurological deficits. Within a few weeks, patients with mild symptoms gradually begin to recover some functions, such as speaking and walking. After 1–−2 years, most patients return to their baseline level, but following such poisoning, cognitive impairment including short-term memory deficits and fatigue may persist and hamper the patient's independence, reducing their quality of life."

 

[sadjenny]

@freelifexit, do you have any idea how easy it would be for a hospital to determine what you had injested? Say you were taken semi-conscious, or you called the ambulance on yourself but didn't disclose the poison. Would they know to think "SN"?

 

[freelifexit]

@freelifexit, do you have any idea how easy it would be for a hospital to determine what you had injested? Say you were taken semi-conscious, or you called the ambulance on yourself but didn't disclose the poison. Would they know to think "SN"?

I read the comment about the failed attempt. Doctors contacted toxicologists and they suggested it was sodium nitrite and an antidote was administered. There is also a case of a guy from Germany when the doctors did not determine what he drank, but they also picked the right antidote.

 

[Mimi_]

@freelifexit, do you have any idea how easy it would be for a hospital to determine what you had injested? Say you were taken semi-conscious, or you called the ambulance on yourself but didn't disclose the poison. Would they know to think "SN"?

The color of the blood turns dark brown after ingested SN, so they will suspect it if they make a blood test.
SN also makes your skin blue

 

[leeloosnow]

quick comment- there's links here and plenty of med reviews abt the usage of vitamin C (ascorbic acid) being used to treat methemoglobinemia (SN od) so that is a very accessible way to prepare for possible treatment, with a few easy searches. Could probably find MB somewhere online or at a shop depending on what country it is. I would also write notes about my wishes for DNR (do not resuscitate) DNI (do not intubate) what meds I am on, what I have taken, last thoughts, some combination of that would be handy in certain situations.

 

[sadjenny]

I read the comment about the failed attempt. Doctors contacted toxicologists and they suggested it was sodium nitrite and an antidote was administered. There is also a case of a guy from Germany when the doctors did not determine what he drank, but they also picked the right antidote.

The color of the blood turns dark brown after ingested SN, so they will suspect it if they make a blood test.
SN also makes your skin blue

Thank you both.

 

[Kta1994]

There are no negative info about consequences from people who failed SN on this forum, except two cases who got problems with kidneys.

But there is info from this Russian article about SN poisoning consequences (first two paragraphs on page 6).

"In severe cases of intoxication due to degenerative changes in erythrocytes and a decrease in their resistance, hemolysis and secondary hemolytic anemia occur (on the 3-5th day after poisoning). In this case, hemoglobinuria, kidney damage (nephropathy with varying degrees of acute renal failure) and liver damage (toxic hepatopathy) can be observed. Severe acute vascular insufficiency (nitrite shock), coma, pulmonary edema may develop. The clinical picture of poisoning is highly variable. In some cases, changes in the respiratory organs come to the fore, in others - in the cardiovascular and central nervous systems, in others - in the blood system."

Also there are no comments about brain damage on this forum from people who failed SN.

But there are several articles which say that brain damage is possible.

From this article (Page 2, Discussion, 2nd paragraph): "Nitrite is also a potent vasodilator and can
cause coronary ischemia and stroke as a result of hypotension, tachycardia, and hypoxia."

Also article about survived case with brain damage: "Delayed post-hypoxic leukoencephalopathy (DPHL) is a demyelinating syndrome that occurs days to weeks after the brain has recovered from a coma. It is caused by the period of hypoxia and is characterized by mental disorders, extrapyramidal system symptoms, and motor changes. Common causes include cardiogenic shock, severe anemia, massive blood loss, and poisoning. There are only a few reports of DPHL due to nitrite poisoning in literature.

Most patients usually recover completely. However, DPHL can easily induce long-term neurological deficits. Within a few weeks, patients with mild symptoms gradually begin to recover some functions, such as speaking and walking. After 1–−2 years, most patients return to their baseline level, but following such poisoning, cognitive impairment including short-term memory deficits and fatigue may persist and hamper the patient's independence, reducing their quality of life."

Thanks, do you know if propanolol is good for the tachycardia and if it makes it easier to go unconscious?

 

[freelifexit]

Thanks, do you know if propanolol is good for the tachycardia and if it makes it easier to go unconscious?

I don't know exactly, maybe someone else can answer.

 

[nonialabaster]

quick comment- there's links here and plenty of med reviews abt the usage of vitamin C (ascorbic acid) being used to treat methemoglobinemia (SN od) so that is a very accessible way to prepare for possible treatment, with a few easy searches. Could probably find MB somewhere online or at a shop depending on what country it is. I would also write notes about my wishes for DNR (do not resuscitate) DNI (do not intubate) what meds I am on, what I have taken, last thoughts, some combination of that would be handy in certain situations.

It sounds like you have been very thoughtful about this. Cover all your bases.

Unfortunately, in Texas, at least, A DNR is a legal document, only given with a life-ending illness. I remember having to sign one for Mark, when he entered hospice care. It had to be notarized, but they were able to get it notarized by proxy for me. I knew it had to be done, but I still felt like I was signing his death warrant.

There was also a stern warning that, if I called an ambulance instead of hospice, he'd be immediately removed from their care. That's just the way hospice operates, and with good reason. Any time his distress became too much, I'd call them and have a nurse on the phone with me and one at the house, right away.

 

[calssilva]

hello ! I am from Brazil too...have u get your SN in Brazil ?

 

[Kta1994]

hello ! I am from Brazil too...have u get your SN in Brazil ?

Hi!! Not yet, i dont have a job and cant at all because of my health, so i depend on my mom, im waiting some time to see if my life improves a least a little, if not, im planning to do before the next year, what about you?