Question

A 22-year-old patient who has recently taken Dapsone for a dermatitis condition is admitted to the emergency department. Her skin is slate gray and the patient is unconscious with shallow respirations and does not respond to painful stimuli. The patient is intubated and resuscitated with 100% oxygen.

Following intubation, the SpO2 remains 85% and the patient remains cyanotic.
what other procedures can be done?

Answer 1

The 22-year-old patient presenting with signs of methemoglobinemia due to Dapsone overdose requires specific treatment with intravenous methylene blue, supportive measures, and possibly the use of a hyperbaric chamber to increase blood oxygen concentration.

Step-by-step explanation:

A 22-year-old patient who has been treated with Dapsone for a dermatitis condition is presenting with a slate gray skin color and is unconscious with shallow respirations. Despite being resuscitated with 100% oxygen and intubated, the patient's SpO2 remains at 85% and they remain cyanotic. This clinical picture is concerning for Dapsone overdose, which can lead to methemoglobinemia, a condition in which hemoglobin is modified to methemoglobin that does not carry oxygen effectively.

The treatment for methemoglobinemia, suspected in this case due to the Dapsone usage and symptoms, would include intravenous methylene blue, which is a specific antidote. As supportive measures, continuous monitoring of vital signs, administration of intravenous fluids, correction of acid-base imbalances, and, if necessary, blood transfusions may be required. The usage of a hyperbaric chamber could also be considered, as it has been used in certain cases of severe hypoxemia to help increase the concentration of oxygen in the blood.