UMEM Educational Pearls

Category: Toxicology

Title: Why is the urine this color?

Keywords: carbon monoxide, rhabdomyolysis, hydroxycobalamin (PubMed Search)

Posted: 2/28/2013 by Fermin Barrueto, MD
Click here to contact Fermin Barrueto, MD


A foley is inserted in a fire victim patient. Urine return is in picture. Describe the reason for this colored urine.

Special Thanks to Dr. Doug Sward for the urine picture 


Rhabdomyolysis causes a tea colored urine and can be seen in carbon monoxide poisoning. This picture is NOT from rhabdomyolysis.

In some fires, especially if there was a lactate > 10mmol/L, patients may also suffer from inhaled cyanide poisoning. Adminstration of the cyanide antidote, hydroxycobalamin, will cause an artificial drop in your pulse ox during administration due to the color of the infused liquid. It will, as the picture is showing, also change the color of the urine.


1302281842_Foley-Sward.jpg (4,224 Kb)