Survival after self-poisoning with sodium nitrite: A case report

J Am Coll Emerg Physicians Open. 2022 Mar 17;3(2):e12702. doi: 10.1002/emp2.12702. eCollection 2022 Apr.

Abstract

Sodium nitrite ingestion poses a considerable public health threat. The incidence of sodium nitrite self-poisoning in the United States has been trending upward since 2017. Our case report describes an intentional sodium nitrite ingestion with favorable outcomes. We highlight the proper treatment of this ingestion with intravenous methylene blue. Sodium nitrite is an oxidizing agent that is commonly found in processed meats, fish, and cheeses as a preservative, antimicrobial, and food coloring agent. It is an odorless, white crystalline powder that has been confused for table salt or granulated sugar. It has become more readily available in large quantities online. Unfortunately, online forums exist that detail how to dose sodium nitrite for suicide. Furthermore, it has been recently discussed in popular news streams after a celebrity died of an overdose. Sodium nitrite toxicity is capable of causing severe methemoglobinemia with high mortality. Prompt identification is crucial. We discuss the important implications in regard to media coverage, imitative suicide, and accessibility of sodium nitrite.

Keywords: ingestion; methemoglobinemia; poisoning; sodium nitrite; toxicology.

Publication types

  • Case Reports