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Subject: Re: [DCHAS-L] Vaseline and oxygen
Date: October 20, 2012 8:07:07 AM EDT
Author: Daniel Crowl
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Subject: Re: [DCHAS-L] lab remodel with chemical safety in mind
Date: October 20, 2012 9:40:19 AM EDT
Author: "Chance, Brandon"
There is no abstract because it is a short letter.
In the otherwise excellent article, 'Oxygen therapy for older people', in your last issue, the myth of not using petroleum jelly (eg Vaseline) on patients' lips if they are receiving oxygen is perpetuated.
There is very little literature or evidence on this issue, but the one valid piece of nursing evidence I have seen is Winslow EH, Jacobson AF (1998) Dispelling the  petroleum  jelly  myth. American Journal of Nursing. 98, 11, 16.
Some American nurses researched this issue. They tried setting fire to petroleum jelly, and only succeeded in melting it. They traced the myth back to manufacturers of oxygen equipment, who meant grease should not be placed on connections for oxygen piping, but unfortunately were not sufficiently specific in their wording. The above article seems to allude to a similar source.
My colleagues and I who work in intensive care regularly place petroleum jelly on the lips of our patients. We probably use more oxygen per patient than any other clinical area and I have never seen nor heard of any patient in ITU either exploding or (the lesser version of the myth) suffering burns to their lips. I have, however, during the course of my career seen many nil-by-mouth patients who suffered from cracked lips.
Further nursing research on this issue would be very welcome, but in the meantime the evidence from the above American research indicates that it is safe to apply petroleum jelly to the lips of patients, and to fail to do so if the patient is at risk of tissue damage (which patients receiving oxygen are) is potentially negligent.
Philip Woodrow Practice Development Nurse Critical Care
Gale Document Number:  GALE|A122028193
I stand corrected on the need for an ignition source.  Nothing like seeing throat cancer patients in VA hospitals wearing supplemental nasal prong O2 and smoking cigarettes through their tracheostomies as used to occur with some deadful regularity in times past.
I suppose a Pubmed or Toxline search (National Library of Medicine) might turn up any incidents that were published in the peer-reviewed medical/scientific literature.
I can say that involving medical supplemental O2 and vasoline, I've never personally come across a case despite practicing in 5 separate fields of medicine since 1977, but that doesn't mean much.
Date: Fri, 19 Oct 2012 09:09:00 -0700
From: neal**At_Symbol_Here**CHEMICAL-SAFETY.COMTo: DCHAS-L**At_Symbol_Here**MED.CORNELL.EDU
Subject: Re: [DCHAS-L] Vaseline and oxygen
Alan =96 you do not need an ignition source the heat of oxidation is sufficient
It would be interesting to locate actual PT incidents.  Where would they be documented?  I no longer have an NFPA membership, so cannot search them.
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ACSafety has a new address:NEAL LANGERMAN, Ph.D.
ADVANCED CHEMICAL SAFETY, Inc.
PO Box 152329
SAN DIEGO CA 92195
011(619) 990-4908 (phone, 24/7)
We no longer support FAX.
I think you will find that home medical O2 providers will always caution against using vasoline (petrolatum jelly) on the face and particulalry to lubricate the nasal mucosa which even with moisturization aerosols  afflicts those receiving chronic medical O2.  What they generally recommend is a lubricating cream which does not contain volatile hydrocarbons.  These are readily available.
Naturally, there would have to be an ignition  source before a fire could occur, but why take a chance when safer alternatives are available?  Nothing like process product substitution as a good administrative approach to hazard/risk reduction.
My late first wife was on supplemental medical O2 for the last 5 years of her life, so I did become quite familiar with this issue.  Whethere there's any real science behind it or whether it is an "urban myth", I can't say as of today.  But the old saw about "better safe than sorry" does come to mind.
Maybe someone wants to do a little bench research in a proper facility and tell us the results?
Alan H. Hall, M.D.
Date: Fri, 19 Oct 2012 08:31:37 -0600
Subject: [DCHAS-L] Vaseline and oxygen
Just curious about this and thought some people on this list-serve might have some insightful thought on a topic I stumbled upon (and if I were still a teacher would be a fun test questions to throw at students just to get them thinking).
I had a newborn nephew who was recently on portable oxygen. At some point my sister-in-law said you aren't allowed to have perfume or Vaseline near the oxygen because it can catch on fire. This struck me as odd that she would be cautioned this way since she was using some type of solvent soaked pad to clean the spot where she was going to be putting an adhesive for the oxygen tube to be put on my nephew's face.
I have never thought of Vaseline being particularly hazardous, so of course I immediate began to consult with Dr. Google. One of the warnings I found online was:
"Never use oil-based face or hair creams, a hair dryer or an
electric razor. It is possible in certain conditions that the combination
of oxygen, oil-based toiletries and a spark from an electrical
appliance, such as an electric blanket, hair dryer, electric razor or
heating pad, could ignite and cause burns. Never use oil based hair
lubricants, face and hand lotions, petroleum jelly products, or
aerosol sprays. Always use water-based cosmetics or creams." (http://www.firsttoserve.com/files/cylinder_oxy.pdf)
I also thought found the article titled "Dispelling the Petroleum Jelly Myth" (someone posted the article in a forum found here http://respiratorytherapydriven.blogspot.com/2007/11/vaseline-and-oxygen-flame-on.html).
Then I decided to call a real medical doctor (my sister) to ask about it. She said that she doubted there was any hard evidence out there that this is a hazard, but that somewhere, someone had an accident, hospital got sued, and now it is a "risk" that is being mitigated in hospitals (including hers).
Anyone out there done experiments to try and catch Vaseline on fire? Anyone know the case where Vaseline was identified as a root cause in an accident involving a patient being burned?
Beyond a intellectual curiosity on the topic, it makes me wonder how we promote safety and what we ask people to focus on. Is is scientifically based (does it need to be)? Is it a knee jerk reaction? Is it a systematic approach? The cartoon below portrays how some people I have spoken to look at OSHA regulations. The problem is that if this is the view a person has of safety regulations/standards, I believe he or she will lose faith in the regulations, potentially not following them and thus losing the benefit they can provide. (Disclaimer: I put this cartoon here not because it is how I view OSHA regulations, but because i think it can help spur conversation.)
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