Management of Paraquat Poisoning

Initial Assessment and Management

The American Heart Association, as published in Circulation, recommends contacting a poison control center immediately for expert guidance in cases of paraquat poisoning 1
The American Thoracic Society recommends removing all contaminated clothing and jewelry to prevent continued exposure, although the source of this guideline is not a primary medical society, it is still relevant 2

The British Thoracic Society recommends that in paraquat poisoning, oxygen should be administered only if the saturation falls below 85% and reduced or stopped if the saturation rises above 88%, as supplemental oxygen may worsen paraquat toxicity 3, 4
The target oxygen saturation in paraquat poisoning is 85-88%, significantly lower than typical critical care targets, according to the British Thoracic Society 3, 4
The British Thoracic Society advises avoiding supplemental oxygen unless the patient is severely hypoxemic (SpO2 <85%) 3
If oxygen saturation rises above 88%, the British Thoracic Society recommends reducing or stopping oxygen therapy 4

The American Heart Association, as published in Circulation, recommends providing standard airway management and treatment of hypotension or dysrhythmias alongside specific paraquat management 1

Healthcare workers must use appropriate personal protective equipment, such as gloves and protective clothing, when handling the patient or contaminated materials, as recommended by the British Medical Journal 5, 6

The American Heart Association, as published in Circulation, recommends providing standard airway management if respiratory distress develops, treating hypotension and dysrhythmias according to standard protocols, and administering benzodiazepines for seizures or severe agitation if they occur, with a strength of evidence based on standard protocols 7
The American Heart Association, as published in Circulation, also suggests maintaining continuous contact with poison control center for evolving treatment recommendations, which is crucial for ongoing management 7