Treatment for Paraquat Poisoning

Initial Management

• Ensure rescuer safety by wearing protective clothing and gloves to prevent direct skin contact and inhalation of toxic fumes when handling the victim's clothes or body fluids, especially vomit, as recommended by the British Medical Journal and Thorax 1, 2
• Seek advice from poison information centers immediately for guidance on specific treatment, according to the American Heart Association 3
• Provide supportive care with focus on airway management, hemodynamic support, and correction of metabolic derangements, as suggested by the American Heart Association 3

Decontamination Measures

• Remove contaminated clothing and thoroughly wash exposed skin areas, as recommended by the British Medical Journal 1
• Consider multiple-dose activated charcoal (15-20g every 6 hours) only after airway protection and hemodynamic stabilization, according to the American Journal of Kidney Diseases 4

Oxygen Management - Critical Consideration

• Avoid supplemental oxygen unless oxygen saturation falls below 85%, and reduce or stop oxygen therapy if saturation rises above 88%, as recommended by Thorax 2
• Target oxygen saturation of 85-88% as paraquat toxicity is worsened by high oxygen concentrations, according to Thorax 2
• Oxygen can increase paraquat-induced free radical production and worsen lung injury, as reported by Thorax 5