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A 45-year-old female develops cyanosis after using topical benzocaine on her toddler. She has a mild headache, SpO₂ 85% on room air, HR 98/min, RR 18/min, BP 126/78 mmHg. ABG PaO₂ = 12 kPa; MetHb = 24%.
Most appropriate immediate management?

Administer high-flow oxygen and observe

Initiate exchange transfusion

Start hyperbaric oxygen therapy

Give IV methylene blue

Administer oral ascorbic acid

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