Multidisciplinary collaborative treatment of 48 cases of village cluster acute nitrite poisoning: A case series study

This report aims to evaluate the effectiveness of a multidepartment collaborative response system in managing a large-scale nitrite poisoning incident in rural China, focusing on organizational strategies and clinical interventions.

Forty-eight villagers collectively developed symptoms after a village banquet, primarily including dizziness, vomiting, and cyanosis of the lips and nail beds. The onset of symptoms occurred 0.5 to 1.5 hours after ingestion.

Based on the diagnostic criteria for acute dietary nitrite poisoning and confirmed by Centers for Disease Control and Prevention (CDC) laboratory tests showing elevated nitrite levels in biological samples (>15 mg/kg), all patients were definitively diagnosed with acute nitrite poisoning.

A multidepartment collaborative emergency response mechanism was activated, implementing prehospital transport and graded management: Mild cases (37 patients) received induced vomiting, oxygen therapy, and intravenous methylene blue (1-2 mg/kg). Severe cases (10 patients) received intensified methylene blue therapy alongside organ function support, with eligible patients undergoing continuous renal replacement therapy.

All 47 hospitalized patients recovered and were discharged after treatment. One patient died before reaching the hospital due to underlying diseases, deeper intoxication, and delayed medical attention.

This rescue effort validates the effectiveness of the multidepartment collaborative model for responding to mass poisoning incidents in rural areas. Key lessons include: Graded transport and early methylene blue administration are crucial for improving prognosis. Cross-institutional information exchange enhances response efficiency. There is an urgent need to strengthen primary-level emergency response capacity and public health education. This framework provides a replicable model for similar resource-limited settings.