oxygen and vaseline

[nrsman1]

Ok. I have heard that vaseline or carmex being used on the patients lips or nose that is using oxygen can be combustable. Is is true. and if so is is evidenced based practice not to use it. And finally if it is combustable and dangerous, is there an alternative?

[Tait, MSN, RN]

I believe the spark can be static electricity from what I am reading.

Tait

[nightmare, RN]

Found this in Nursenet archives,

Quote

This is one of those Things That Will Not Die. The best argument against it is the Material Safety Data Sheets. They show the flash point of petroleum jelly to be around 400 degrees F and an ignition temperature of around 540 degrees. This is not all that much different from the same indices on the plastics used in the oxygen equipment.

Another argument against this concern is the fuel load. You just don’t put enough Vaseline on any one person to support combustion for any length of time. I think this stems from two sources. (1) you should not use

petrolatum on oxygen equipment because it can degrade the washers, etc. for the valves and cause leaks. (2). the Material Safety Data sheets say that you should keep it away from oxidizers. (this is largely a storage problem). If you have a fire with oxygen running, the absolute least of your worries is going to be a dab of vaseline around the nares or the lips. The sheets, for instance, can be impregnated with oxygen and burn much faster. The oxygen itself until you turn it off will overwhelm any burning from the vaseline. Anyone interested can Google vaseline on sci.med.nursing and look at the last time this came up there. This is right up there with degree status as a major flame (pun intended) generator.

[hypocaffeinemia, BSN, RN]

According to this, it has an autoignition temperature >290°C

While an increase in oxygen lowers this temperature somewhat, I wager the patient has bigger problems to worry about if the temperature of his skin is greater than ~45°C.

Therefore it is safe to say that spontaneous combustion is impossible.

--

However, it's flash point is 182-221°C.

The temperature inside a cigarette can be 700°C or more! (link)

[Virgo_RN, BSN, RN]

Tait said:

I believe the spark can be static electricity from what I am reading.

Tait

Thank you. That seems plausible. Anybody have any references to this actually happening?

[dianah, ASN]

i did an internet search, stopping at the first thing i found that might help:

issue: volume 98(11), november 1998, p 16rr

publication type: [research for practice]

publisher: © 1998 lippincott williams & wilkins, inc.

institution(s): elizabeth h. winslow is a research consultant for the presbyterian hospital of dallas, tx. ann f. jacobson is an assistant professor at kent state university school of nursing, kent, oh.

table of contents:

≪ the essential role of pastoral care: a clinician's perspective.

≫ patient protections.

links

complete reference

recently, a hospital with which i have been associated removed petroleum jelly from the patient-care units to prevent its use on patients receiving oxygen. the ban was based on the national fire protection association's (nfpa) 1996 edition of its standard for health care facilities, which states, "oil, grease, or other flammable contaminants shall not be used with oxygen equipment" (item 8-6.2.2.2), and "flammable and combustible liquids shall not be permitted within the site of intentional expulsion" (item 8-6.2.2.3). the hospital's administration inferred that petroleum jelly presented a fire hazard. ironically, no ban was placed on petroleum-based products such as antibiotic ointments, petroleum jelly gauze, and hand or body lotion, which are commonly used in caring for patients receiving oxygen. no problems had been reported with these products.

many nurses on staff were bewildered and concerned about the ban. they had used petroleum jelly for years to lubricate, soothe, and protect skin and mucous membranes. in many nurses' experiences, water-soluble products, which were permitted, were not effective moisturizers. staff nurses took their concern about the "petroleum jelly prohibition" to the nursing research committee, enlisting their help in validating or refuting the scientific basis of the ban.

the newly formed committee, whose primary goal was to promote evidence-based practice, completed an exhaustive literature search. this provided no evidence of problems associated with using petroleum jelly for patients, whether they were receiving oxygen or not. at one committee meeting, attempts to ignite a glob of petroleum jelly were unsuccessful-the petroleum jelly simply melted into a large puddle. an internet inquiry and phone calls to staff nurses working at hospitals in the area and across the nation generated a long list of hospitals with no restriction on petroleum jelly use and a short list of hospitals who were queried had ever heard of an adverse incident caused by petroleum jelly. an informal phone survey to nationally recognized nurses produced similar responses. for example, marianne chulay, dnsc, rn, faan, past-president of the american association of critical-care nurses, and cathie guzzetta, phd, rn, faan, author of several books on the nursing care of critically ill patients, both used petroleum jelly for patient care and neither had ever encountered or heard of a problem with it. the physician chair of the nfpa technical committee on gas delivery equipment offered his personal interpretation of items 8-6.2.2.2 and 8-6.2.2.3. he construed 8-6.2.2.2 as referring to oxygen equipment hardware, such as valves and regulators, and 8-6.2.2.3 as literally pertaining to liquids only (personal communication, december 10, 1996). he cautioned, however, that his opinion should not be considered an official commentary.

despite the above evidence, safety committee and risk management personnel were reluctant to allow petroleum jelly for patients receiving oxygen. the hospital safety manager requested assistance from an independent physician researcher to resolve the issue. the researcher noted that petroleum jelly "is neither a contaminant nor a liquid" and urged that "the present uses of petroleum jelly, with its many solidly demonstrated benefits to patients, be continued without restriction until such time as solid scientific evidence becomes extant which would indicate a potential hazard to patients, staff, or premises" (memorandum from ivan danhof, december 5, 1996). finally, the ban was lifted.

[lpnflorida]

Dianah, great article.

Call my education way old, but I was taught not to use vaseline for nasal membranes due to the slight chance of causing aspiration pneumonia. Hence I have never used vaseline for that purpose. I will use the water soluble formulas.

[NurseCard, ADN]

I've never understood this. Oxygen is combustible, so is vaseline, but the two of them together? How do they cause each other to combust?

Anyway, there are several replies and I'm posting before I read the replies so.. perhaps one of you had some insight. I'll sit back and shut up and read now.

[Valerie Salva, BSN, RN]

Can you imagine the headline?

Nurse puts Chapstick on pt's lips- burns down hospital.

[hypocaffeinemia, BSN, RN]

RealNurseWitch said:

I've never understood this. Oxygen is combustible

Oxygen is not combustible. It is an oxidizer which facilitates combustion.

[tencat]

Pooh. I've never heard of it happening that when one uses vaseline and oxygen a fire ensued. Now if they were SMOKING, using vaseline and oxygen......Yup, heard of that ONE! Results in pretty good fire........

[HappyBunnyNurse]

I have to agree with whoever said if a patient with oxygen catches fire vaseline will be only a small concern. Am I the only one who wishes they had been in the meeting where they tried to set the vaseline on fire? Lol.

[2008pn]

H2O soluble lubricant all the way, better for the patient!