Contraindication for 02

[OVeractiveBrain]

A medic preceptor today told me there is one contraindication for oxygen.

It was a quite often used street drug that is no longer in fashion. It sounded something like periquot (like aliqout, but peri) though we couldnt find anything about it on the internet. I was wondering if anyone had any legitimate reasonings behind this so call-ed contraindication to high flow 02.

No, Hypoxic drive is still not a contraindication for high flow 02 in teh acute setting. This is supposedly the ONLY contradindication for high flow 02 and that is an overdose on this medication. Wondering what it is and what the mecahnism could possibly be

OveractiveBrain

[Ridryder 911]

Actually that is not true. Paraquat was a chemical that was sprayed on marijunia to decrease the sales. Oxygen did cause a burning sensation, and many felt it was dangerous.. but no proof. Here is some information:

[web:3dea2dbe78]http://www.bt.cdc.gov/agent/paraquat/basics/facts.asp[/web:3dea2dbe78]

[john51071]

This information is from an emergency medicine website. The article was written by Lewis Nelson, MD. As always, if the patient condition warrants it, give O2! However, giving it "because you can" in this case could possibly harm the patient.

"Paraquat has an affinity for the lung, in which it is selectively absorbed and accumulates within type I and type II alveolar epithelial cells. Within these cells, paraquat generates oxygen free radicals that ultimately damage lipid membranes and cause cell death.

Aggressive support is a must for patients who ingest paraquat. Ironically, oxygen supplementation may have a deleterious effect because it increases the number of toxic radicals. Oxygen should therefore be given only to prevent hypoxemia."

Hope this helped some.

Be safe out there,

John

[hammerpcp]

This information is from an emergency medicine website. The article was written by Lewis Nelson, MD. As always, if the patient condition warrants it, give O2! However, giving it "because you can" in this case could possibly harm the patient.

"Paraquat has an affinity for the lung, in which it is selectively absorbed and accumulates within type I and type II alveolar epithelial cells. Within these cells, paraquat generates oxygen free radicals that ultimately damage lipid membranes and cause cell death.

Aggressive support is a must for patients who ingest paraquat. Ironically, oxygen supplementation may have a deleterious effect because it increases the number of toxic radicals. Oxygen should therefore be given only to prevent hypoxemia."

Hope this helped some.

Be safe out there,

John

Hey John,

Just curious as to what your source for this info is.

[medic001918]

See, I wasn't totally crazy when I mentioned this today. It's amazing who lurks on the boards. I couldn't remember the proper spelling to look it up today.

Here's some information from http://adam.about.com/encyclopedia/001085.htm on paraquat lung:

"Severe ingestion of Paraquat can rapidly cause death from respiratory failure due to a form of proliferative alveolitis, or inflammation of the air spaces in the lungs. This impairs oxygen transport to the blood and may lead to acute respiratory distress syndrome (ARDS).

Administering oxygen to improve the blood oxygen level may actually increase the damage to the lung in such cases of ARDS. Chronic exposure to Paraquat, may cause pulmonary fibrosis, or a stiffening of the lung tissue."

And taken from http://www.ijnephrol.com/aprjune2003/23.htm

"As oxygen potentiates paraquat lung toxicity, supplemental oxygen should not be given as an initial measure. Oxygen is recommended only if FIO2 falls below 50 14. Recently there has been some interest in using nitric oxide to treat paraquat-poisoning 15. Paraquat specific IgG antibodies and their Fab fragments are effective but the “window of opportunity” is very short, only a few hours at the most 16. Lung transplantation has been performed in a few patients 17.

The mortality of paraquat poisoning remains high. Multi-organ failure with circulatory collapse is associated with 100% mortality, early in the course of disease while late pulmonary fibrosis with respiratory failure also remains an important cause of mortality 7, 10, 18. The survival rate in our study is 41%. On comparing the different variables amongst survivors and non-survivors, the severity of poisoning, late referral to hospital and multi organ system failure showed increased mortality."

And taken right out of Idaho's BLS guidelines http://www.healthandwelfare.idaho.gov/_Rai...dult_oxygen.pdf

And finally another MD written document at http://www.prn2.usm.my/mainsite/bulletin/sun/1997/sun13.html

"Prevention of pulmonary damage

Paraquat is known to accumulate selectively in lung tissues and destruction of the tissues is exacerbated by the administration of oxygen. Thus it is suggested that the minimal oxygen is given to the patient to reduce the damage caused by the oxygen."

Some reading for you. Enjoy.

Shane

NREMT-P

[Andrewtx]

Hey John,

Just curious as to what your source for this info is.

Googled it because I was bored.

http://www.emedmag.com/html/pre/tox/0502.asp

[Dustdevil]

Wow, long time no see, John!

Welcome home, and thanks for the great post!

[ERDoc]

Although it is not labeled as such, oxygen should be contraindicated in cases of stupidity (including the 21% that occurs naturally), though that is just my rambling opinion at 4am. Sorry, back to your regularly scheduled thread.

[Dustdevil]

Although it is not labeled as such, oxygen should be contraindicated in cases of stupidity (including the 21% that occurs naturally)...

I think that was the whole idea behind spraying pot with paraquat in the first place.

[tniuqs]

I think that was the whole idea behind spraying pot with paraquat in the first place.

Back to the regular sheduled thread........

Then best buy CANADIAN ? LMFAO......and we practice playing Doctor in Alberta @ about 8 years of age!

As for other meds that require serious monitoring add Bleomycin to the "almost absolute" contraindications.