Type of poisoning where giving O2 is instanty fatal

[JPINFV]

Yeah but if you've got a kid with say TOF, NSAIDS would be like giving epi to someone having a good sized MI.

TOF? Meh. It's helpful, but you aren't going to close all of the routes. Now Transposition of the Great Vessels? It's a death warrant.

 

[tickle me doe face]

No, because molecular oxygen has a double bond. So you have 2 pairs of unbounded electrons on each molecule as well as a sigma bond and a pi bond linking the two oxygen molecules.

but if O2 had no unpaired electrons it wouldn't be able to interact with a magnetic field right?

also i thought that if you you drew molecular oxygen and started adding it's electrons, the very last 2 would go into degenerate p orbitals, and since every single orbital must be occupied before electrons start pairing off, the end structure would have 2 unpaired electrons?

 

[fast65]

Every single person I've ever put an NRB on as a Paramedic has ended up getting intubated.


Just sayin'.

Same here...well except the guy yesterday, I had the Sux and Roc all drawn up and then I didn't even get to use them

 

[usalsfyre]

TOF? Meh. It's helpful, but you aren't going to close all of the routes. Now Transposition of the Great Vessels? It's a death warrant.

Transposition of the Great Vessels was covered superficially in the stuff I just finished studying. My impression was those kids rarely make it past the first hour or so.

 

[JPINFV]

1 S and 2 S is going to fill before 2P fills. So atomic oxygen is going to have 2 unpaired electrons in the 2 P shell. However, since you get a double bond with molecular oxygen, each oxygen molecule is going to share 2 electrons with each other, which will allow you to fill the 2 P shell.

 

[tickle me doe face]

but if O2 had no unpaired electrons it wouldn't be able to interact with a magnetic field right?

also i thought that if you you drew molecular oxygen and started adding it's electrons, the very last 2 would go into degenerate p orbitals, and since every single orbital must be occupied before electrons start pairing off, the end structure would have 2 unpaired electrons?

like in this pucture?

 

[JPINFV]

Transposition of the Great Vessels was covered superficially in the stuff I just finished studying. My impression was those kids rarely make it past the first hour or so.

It's a "get to the OR... NOW" situation. I'm honestly not sure, though, what the mortality rate is.

 

[Cup of Joe]

That's because the NREMT has, for unknown reasons, a proverbial hard-on for administering a high concentration of oxygen. If it was appropriate, how come not everyone in the emergency department is chilling with a NRB on?

Because the book is the book, and the street is the street. On the street, EMTs are exhibiting their "good clinical judgement" when they don't follow protocol word for word. When you take a class, they teach you to pass a test. And if the NREMT tests to the idea that everyone gets oxygen, then the class teaches you that everyone gets oxygen.

So if I called 911 because I stubbed a toe, your instructors would put me on a NRB?

Ok, then follow the protocol to a T. The initial assessment section still says, "when appropriate" and the later protocols specifically say "high concentration of oxygen." If you want to play the protocol book game, then it's appropriate when utilizing one of those specific protocols.

The tests tell you you should. Utilizing good clinical judgement, it can be debated whether you need it or not, which is why we wouldn't give it unless indicated.

As to following specific protocols, they're there as a model. Every patient is different and some may not even fit the model, which is why the state writes that it is not a substitute for good clinical judgement.

 

[JPINFV]

Huh... looking at the page source for that (http://courses.chem.psu.edu/chem210/) is interesting and leads me to believe that you know more than you let on. I honestly don't remember if it was presented similar to that during undergrad chem and o-chem (we're talking 6 years ago). However, it also shows why oxygen isn't as safe as it's made out to be. Finally, it's not nearly reactive as a radical alone.

 

[the_negro_puppy]

For us supplemental 02 is contraindicated for lung disease secondary to bleomycin therapy and known paraquat poisoning.

Paraquat>

 

[tickle me doe face]

For us supplemental 02 is contraindicated for lung disease secondary to bleomycin therapy and known paraquat poisoning.

Paraquat>

not even a little bit?

even if they are severly hypoxic?

 

[mikie]

sad part is...i knew the answer

according to the Mosby paramedic pharmacology flashcards, the only contraindication to O2 is indeed "known" paraquat poisoning.

 

[tickle me doe face]

I'm so lost now....

Wait, I'm confused again :blink:

basically, doesn't paraquat accumulate in alveolar epithelial cells, and cause damage through a mechanism that generates oxygen free radicals?

And if that is the case, and o2 was administered, and if o2 is triplet o2, and is di radical, why wouldn't it couple with the radicals generated via the paraquat and terminate the radical process?

Or if O2 was singlet o2, which is a known ROS, still terminate radical polymerization?

By that way of thinking how can o2 be contraindicated in paraquat poisoning???:unsure:

It sure seems like o2 would "eat up" oxygen free radicals resulting from the paraquat?

I'm getting really nervous for my upcoming NREMT now....

 

[JPINFV]

I honestly can't comment on why O2 doesn't, on a regular basis and spontaneously, form O3 (not that ozone is the healthiest thing to breath anyways) instead of simply splitting off to form a new radical, but it doesn't. I do know that O2 loves making radicals when it can, and that when it gets hit with a radical it tends to make radicals.

In terms of atomic oxygen (O1), yes, when it gets hit with a radical it will neutralize it. The problem is that it also can hit other molecules and make those into radicals, which can cause problems.

 

[Cup of Joe]

I honestly can't comment on why O2 doesn't, on a regular basis and spontaneously, form O3 (not that ozone is the healthiest thing to breath anyways) instead of simply splitting off to form a new radical, but it doesn't. I do know that O2 loves making radicals when it can, and that when it gets hit with a radical it tends to make radicals.

Because O2 is stable as is? All the electrons are pair with another electron so it has no need to bond with another atom? Thats my guess.

 

[akflightmedic]

Wait, I'm confused again :blink:

basically, doesn't paraquat accumulate in alveolar epithelial cells, and cause damage through a mechanism that generates oxygen free radicals?

And if that is the case, and o2 was administered, and if o2 is triplet o2, and is di radical, why wouldn't it couple with the radicals generated via the paraquat and terminate the radical process?

Or if O2 was singlet o2, which is a known ROS, still terminate radical polymerization?

By that way of thinking how can o2 be contraindicated in paraquat poisoning???:unsure:

It sure seems like o2 would "eat up" oxygen free radicals resulting from the paraquat?

I'm getting really nervous for my upcoming NREMT now....

Sock puppet strikes!

 

[samiam]

To answer the original question, giving high-concentration O2 to a neonate who is PDA dependent (any of the cyanotic heart lesions) would be pretty rapidly fatal as well.

When I was born I came out blue and was put on O2 even though I had a PDA... What is the mechanism behind that?

 

[Aidey]

He specified high concentration O2, not O2 period. We occasionally transport out of town teams, and we had a neonate with transposition of the great vessels who was on .5lpm O2.

 

[usalsfyre]

When I was born I came out blue and was put on O2 even though I had a PDA... What is the mechanism behind that?

The ductus arteriosis is supposed to be closed via oxygenation at birth, the issue is when infants require a PDA to mix in oxygenated blood due to congenital abnormalities.

 

[silver]

The ductus arteriosis is supposed to be closed via oxygenation at birth, the issue is when infants require a PDA to mix in oxygenated blood due to congenital abnormalities.

Yep these ductal dependent lesions include Tetralogy of Fallot, pulmonary atresia/stenosis, and transposition of the great vessels. Closing the PDA, giving O2, would not be good...