Butyl Nitrite and a Suicide Attempt

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To the editor: A patient recently seen in our emergency department proved the value of the early recognition and treatment of methemoglobinemia recommended by Shesser and associates in their letter in your January issue (1). A 30-year-old black man was brought by ambulance to the emergency department from a movie theater, where he had been found semicomatose. His pulse was 130/min, blood pressure 70 mm Hg/palpable, and respirations 26/min. His pupils were both 3 mm, round, and reactive to light, and he moved all extremities appropriately in response to painful stimulation. Prehospital care by emergency medical technicians consisted of oxygen

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