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- Mar 2, 2006
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Just a reminder (or an alert to those who didn't know), that hurricane spray/benzocaine can cause your patient to turn gray and their blood to turn maroon-brown and you to have an involuntary butt spasm
Heard a code blue called to our obs unit the other day. RT was with me later on for an extubation in the ICU, turned to me and said, doc, you gotta see this abg result! Pt was having procedure down in obs (don't know what) and had gotten some hurricane spray. Soon after he turned a lovely ashen color and the SaO2 monitor was reading in the 70's. ABG with PO2 of 333, S02 in 80's. Methemoglobin in 50's. RT reported his blood was the darkest he'd ever seen. Quick lit search shows multiple case reports of topical benzocaine leading to methemoglobinemia. FDA has an alert about same, with recommendations of ONLY 1-2 sprays lasting no more than one second. I don't know about y'all, but I've seen our ENT peeps being much more liberal than that for PTA aspirations and scopes.
So just something to park in your midbrain, along with the tx=> supportive/high 02->methylene blue 1-2 mg/kg->hyperbaric 02 depending on severity
Heard a code blue called to our obs unit the other day. RT was with me later on for an extubation in the ICU, turned to me and said, doc, you gotta see this abg result! Pt was having procedure down in obs (don't know what) and had gotten some hurricane spray. Soon after he turned a lovely ashen color and the SaO2 monitor was reading in the 70's. ABG with PO2 of 333, S02 in 80's. Methemoglobin in 50's. RT reported his blood was the darkest he'd ever seen. Quick lit search shows multiple case reports of topical benzocaine leading to methemoglobinemia. FDA has an alert about same, with recommendations of ONLY 1-2 sprays lasting no more than one second. I don't know about y'all, but I've seen our ENT peeps being much more liberal than that for PTA aspirations and scopes.
So just something to park in your midbrain, along with the tx=> supportive/high 02->methylene blue 1-2 mg/kg->hyperbaric 02 depending on severity