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Cyanosis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

Abnormal bluish discoloration of the skin or mucous membranes 
  • Caused by abnormal elevations of deoxygenated hemoglobin or hemoglobin derivatives in the capillaries:

    • Deoxygenated hemog...

Diagnosis

Signs and Symptoms

  • A bluish discoloration of the skin and mucous membranes that blanches with pressure:

    • Chocolate color:

      • Methemoglobinemia

    • Slate gray color:

      • Methemoglobinemia, sulfhemoglobin

    • Reddi...

Treatment

Pre-Hospital

  • Assess and establish patent airway.

  • Correct any airway obstruction.

  • Recognize an incorrectly placed airway.

  • 100% O2 using a nonrebreathing device

  • Ensure adequate ventilation.

  • Recogniz...

Follow-Up

Disposition

Admission Criteria

  • Most affected patients should be admitted to the hospital.

  • ICU admission is required for any instability or cyanosis.

Discharge Criteria

Reversible causes of hypoxi...

Pearls and Pitfalls

  • First assume hypoxemia and immediately assess airway and breathing

  • Chocolate-colored blood or unchanging oxygen saturation despite aggressive administration of oxygen: Think methemo...

Additional Reading

  • BheemReddy  S, Messineo  F, Roychoudhury  D. Methemoglobinemia following transesophageal echocardiograph: A case report and review. Echocardiography.  2006;23(4):319–321.

  • Kurkli...

Codes

ICD9

  • 770.83 Cyanotic attacks of newborn

  • 782.5 Cyanosis

ICD10

  • P28.2 Cyanotic attacks of newborn

  • R23.0 Cyanosis

SNOMED

  • 3415004 Cyanosis (finding)

  • 119419001 Cyanosis of skin (finding)

  • 95442007 Peripheral cy...

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