CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries CRACKCast E014 - Cyanosis
5 snips
Mar 30, 2016 A focused run-through of cyanosis and how to tell its causes apart. Clear definitions of oxygen measures and the pathophysiology behind blue skin. A practical differential highlighting cardiopulmonary catastrophes and acquired hemoglobin disorders. Deep dive into methemoglobinemia causes, recognition with chocolate-brown blood, and when to use methylene blue. Explanation of the oxygen-hemoglobin curve and the hyperoxia test.
AI Snips
Chapters
Transcript
Episode notes
Cyanosis Means Hypoxia But Can Be Misleading
- Cyanosis is specific but not sensitive for hypoxia.
- You see cyanosis in adults when >5 g/dL deoxygenated hemoglobin, so anemia or polycythemia change its appearance.
Prioritize Critical Causes First
- When assessing cyanosis prioritize life‑threatening causes: heart failure, ACS, shock, respiratory failure, massive PE, or congenital heart disease.
- Rapidly evaluate heart, lungs, and consider pediatric congenital lesions in new presentations.
Cancer Patient Stayed Cyanotic Despite Methylene Blue
- Adam recalled a BC Cancer patient who remained cyanotic despite methylene blue because she had sulfhemoglobinemia from a chemotherapy trial.
- The lack of response to methylene blue prompted a diagnosis of sulfhemoglobinemia.