Dawaa Reference

chronic

Cyanosis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Cyanosis - StatPearls (NCBI Bookshelf NBK559167) - https://www.ncbi.nlm.nih.gov/books/NBK559167/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class SS07.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Cyanosis present since birth suggests a congenital cause; recent onset suggests an acquired one [cyanosis]
  • Cyanosis in the first week of life suggests tricuspid atresia, Ebstein anomaly, or critical pulmonary stenosis [cyanosis · stricture]
  • Cyanosis appearing after the first week suggests tetralogy of Fallot, transposition of the great arteries, or truncus arteriosus [cyanosis]
  • Fever with cyanosis points to an infectious cause such as croup, pneumonia, or septic shock [cyanosis · fever · shock]

Signs — what you find (5)

  • Capillary refill over 2 seconds is typical of peripheral cyanosis [cold peripheries · cyanosis]
  • Peripheral cyanosis resolves with massage and warming [cyanosis]
  • Central cyanosis is best seen on the lips, tongue, and mucous membranes [cyanosis]
  • Digital clubbing can develop with long-standing central cyanosis [cyanosis · finger clubbing]
  • The thin skin over the cheeks, nose, ears, and oral mucosa makes them the best places to check for cyanosis [cyanosis]

Tests (5)

  • Pulse oximetry is the first noninvasive test used to rule out life-threatening hypoxemia
  • Pulse oximetry can falsely read low in peripheral cyanosis or dyshemoglobinemia
  • Arterial blood gas is normal (85 to 100 percent) in peripheral cyanosis but low in central cyanosis
  • Co-oximetry can identify abnormal hemoglobin forms such as methemoglobin or carboxyhemoglobin
  • Pseudocyanosis shows normal readings on both pulse oximetry and co-oximetry

If not this — what else fits (4)

  • Methemoglobinemia or sulfhemoglobinemia should be suspected when central cyanosis fails to improve with oxygen
  • Reversed differential cyanosis, more marked in the upper limbs, occurs with transposition of the great arteries
  • Drugs such as amiodarone or silver can cause gray-blue skin discoloration mimicking cyanosis
  • Pigmentary birthmarks or large tattoos can mimic cyanosis

SourceStatPearls "Cyanosis" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

A clinical sign of low blood oxygen or poor perfusion; the primary care role is urgent recognition, oxygen if available, and immediate referral or emergency transfer rather than routine prescribing. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A clinical sign of low blood oxygen or poor perfusion; the primary care role is urgent recognition, oxygen if available, and immediate referral or emergency transfer rather than routine prescribing.

Cautions
  • Central cyanosis with breathing difficulty or altered consciousness is a medical emergency requiring immediate transfer.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.