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

Rationale: 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. Patient concerns: 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. Diagnoses: 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. Interventions: 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. Outcomes: 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. Lessons: 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.