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- Classic Clinical Finding: Cyanosis out of proportion to clinical symptoms (look real blue but not SOB) - Causative Agents: Benzocaine (and other local anesthetics), dapsone, nitrites, phenazopyridine (Pyridium) - When do you treat: significant tissue hypoxia (MI, CVA, Dysrhythmias), and if MetHb >20% asymptomatic - Treatment: Methylene Blue 1-2 mg/kg (0.1 -0.2 mL/kg of 1% methylene blue) over minutes