PT  - JOURNAL ARTICLE
AU  - Aileen McCabe
AU  - Brendan McCann
AU  - Paul Kelly
TI  - Pop goes the O<sub>2</sub>: a case of popper-induced methaemoglobinamia
AID  - 10.1136/bcr-2012-007176
DP  - 2012 Nov 21
TA  - BMJ Case Reports
PG  - bcr2012007176
VI  - 2012
4099  - http://casereports.bmj.com/content/2012/bcr-2012-007176.short
4100  - http://casereports.bmj.com/content/2012/bcr-2012-007176.full
AB  - A 39-year-old man presented to the emergency department after falling downstairs after he consumed a large quantity of alcohol. On examination, he had altered mental state (GCS 14), central cyanosis and low oxygen saturation of 86%, despite 100% oxygen being administered. His arterial blood gas confirmed diagnosis of methaemoglobinaemia with a methaemoglobin percentage of 14.08. He was treated successfully with methylthioninium chloride. The patient later admitted to use of recreational poppers (amyl nitrates) the previous evening. The emergency physician is challenged by the presentation of a patient with altered mental state and unexplained low oxygen saturation with concurrent alcohol intoxication but must have a high index of suspicion for methaemoglobinaemia particularly with a history of recreational drug ingestion.