A Richmond ER doctor is warning about the dangers of inhaling nitrous oxide (N2O) after treating a 20-year-old woman who experienced hallucinations stemming from daily use of “whippits.”
According to a report published this month in the B.C. Medical Journal, Dr. Matthew Mo Kin Kwok — one of the report’s authors — treated a young Asian woman who came to emergency at Richmond Hospital because she was worried for her safety.
The woman was experiencing auditory and visual hallucinations, agitation and had issues walking, according to the report.
The high from whippits, which produces a dissociative state, typically lasts one to two minutes, according to the report.
As a result of her hallucinations, she was also concerned about an imaginary “transmitting” device in her throat, which she believed was making her legs weak and from which she heard voices telling her to kill herself.
N2O easily accessible
Commonly known as “laughing gas,” N2O is used in a medical setting for purposes such as anaesthesia or sedation.
It’s also commercially available in canisters known as whippits, which are used as a foaming agent in whipped cream dispensers. Whippets can be purchased over-the-counter or online regardless of age, medical history or intended use.
The N2O in over-the-counter whippits is the exact same as what’s used for medicinal purposes.
The woman had no history of psychiatric or medical illness, according to the report, had stable vital signs and showed no sign of head trauma. Other medical tests came back normal.
However, said the report, she told doctors that she inhaled nitrous oxide on a daily basis.
“She had increased her use recently and was inhaling gas from approximately 100 whippits per day,” reads the report.
The patient told doctors she bought the canisters legally using a shopping app and showed the physician the website she used when making the purchases. She did not report any other prescription or recreational drug use.
“A psychiatrist, a neurologist and an addiction medicine physician assessed the patient in consultation and agreed that she was psychotic as a result of N2O use,” reads the report.
And according to the report, the authors found that a package of 100 canisters could be purchased online for less than $100, or $1 per canister.
Lack of reporting a concern
According to the report, there were multiple barriers when it came to reporting the woman’s case.
First, it was difficult to determine which authority to report the case to. For example, if the use of the chemical was medicinal, health care providers would need to report to the Canada Vigilance Program.
But if the chemical comes from a product used for whipped cream, the case should be reported to Health Canada Consumer Products and Cosmetics.
But the response from those authorities was also an issue.
“In response to our report, a Health Canada representative explained that consumer products and cosmetics would document the misuse but only take further action if the (nitrous oxide) canister had faults or hazards regarding its intended use, which is making whipped cream,” reads the report.
The report’s authors were “surprised” to learn that no cases of nitrous oxide misuse had been reported to Health Canada and only one case of substance abuse was reported to the Canada Vigilance Program.
The authors also contacted the B.C. Drug and Poison Information Centre, which informed them that the organization had received 14 calls about nitrous oxide toxicity from misuse of whippets or similar commercial products between 2015 and 2019.
“Since our investigation determined that Health Canada received only one report of N2O misuse in this period, many incidents appear to have gone unreported,” reads the report.
In 2017, the News reported how a 23-year-old Richmond man was almost paralyzed after overdosing on N2O, having bought the gas on WeChat.
At the height of his addiction, the man inhaled more than 1,000 eight-gram cartridges of nitrous oxide every day for two months.
He also said he experienced delusions, such as someone chasing him while he was driving or someone was going to hurt him.
According to Kwok’s report, Health Canada considers N2O to be an “unscheduled non-prescription professional use” product.
“This raises an important question,” reads the report. “If N2O used medicinally is deemed to require health care provider involvement, why is the purchase of N2O used commercially not restricted in any way given the potential impact on consumers?”
Some possible solutions to a lack of awareness around N2O toxicity and its possible serious effects, according to the report, are adding safeguards to minimize harm and encouraging intervention from authorities to prevent misuse.
In a release from Vancouver Coastal Health, Kwok also said both doctors and the public need to be more aware of the possible outcomes of inhaling whippits.
“When people present at the emergency department with unexplained neurological symptoms it’s important for clinicians to consider nitrous oxide as a possible cause,” said Kwok.
“It’s also important for users to know that using this product outside a supervised medical setting can cause serious health effects.”
The Key Role of Trustworthy Babysitters in Balancing Work and Family Life
Are you a busy parent in constant pursuit of the elusive work-life balance? We know firsthand how overwhelming and challenging it can be to juggle professional commitments while still having quality time with your children.
That’s why we’re here to discuss an essential ingredient that unlocks the secret to harmony: trustworthy babysitters.
What Characteristics Parents Should Look for When Choosing a Babysitter?
Parents should look for a few key characteristics when choosing a babysitter. A good babysitter should be patient, responsible, and reliable. They should also be comfortable with children and have prior experience caring for them.
Besides, the babysitter must be able to communicate effectively and follow directions well. The babysitter should be someone the parents can trust to care for their children in their absence.
Strategies for Parents to Establish Reasonable Anticipations
As a parent, finding babysitters you can trust to care for your children is vital. However, it is also important to establish reasonable expectations for your babysitters.
Some tips for establishing reasonable expectations for babysitters include:
- Set clear expectations: Sit down with your babysitter to discuss bedtime routines, dietary preferences, and any necessary medications.
- Allow flexibility: While clarity is vital, also provide room for your babysitter to use their judgment and feel comfortable in their role.
- Trust their expertise: Once expectations are set, trust your babysitter’s judgment as a professional caregiver to avoid undermining their authority and creating discomfort in their role.
Determining a Fair Payment Plan
Determine your babysitting budget, factoring in your income and family size, while researching local rates. Account for the babysitter’s experience and qualifications, giving preference to those recommended by trusted sources.
Engage in open negotiations with your chosen babysitter. This aims to find a mutually agreeable arrangement that accommodates both your budget and their needs.
Tips on Finding Trustworthy and Compassionate Caregivers
When seeking a caregiver for your child, to ensure you find the right fit:
- Seek recommendations from trusted sources such as friends, family, and neighbours who may have suggestions for caregivers in your area.
- Conduct online research to review feedback and check references to gauge candidates’ qualifications and experience.
- Request references and contact details from the caregivers’ previous employers or families they have worked with.
- Trust your instincts and ensure you feel at ease with the caregiver, ensuring they are someone you can entrust with your child’s well-being.
Being able to trust your babysitter means you can have peace of mind knowing your child is safe and cared for.
Spending some time researching online reviews or asking friends and family for recommendations will help you find the perfect fit so you can feel more at ease while juggling work commitments in today’s hectic world.
Facility-wide COVID-19 outbreak at Bethammi Nursing Home
THUNDER BAY — St. Joseph’s Care Group and the Thunder Bay District Health Unit have declared a facility-wide COVID-19 outbreak at Bethammi Nursing Home, part of the St. Joseph’s Heritage complex on Carrie Street near Red River Road.
The respiratory outbreak at the 112-bed facility was declared effective Sept. 15 but only announced publicly on Monday.
No details were provided with regard to the number of people affected to date.
Restrictions are now in place for admissions, transfers, discharges, social activities and visitation until further notice.
Alberta COVID hospitalizations up 73% since July: health minister
Three weeks after the start of the school year, Alberta’s health minister provided an update on the spread of airborne viruses in the province.
Adriana LaGrange also said more information about flu and next-generation COVID-19 vaccines will soon be released.
“Now that we will be spending more time indoors, we need to make doubly sure we are following proper hygiene protocols like handwashing and staying home when sick,” LaGrange said. “It also means respecting those who choose to wear a mask.”
Global News previously reported that influenza vaccines will be available on Oct. 16 with the new Moderna vaccine formulated to target the XBB.1.5 variant likely to be available at around the same time. On Sept. 12, Health Canada approved the use of the Moderna vaccine.
“More information on immunizations against respiratory viruses including influenza and COVID-19 will be available shortly,” the health minister said.
LaGrange said there have been 28 cases of influenza and five lab-confirmed cases of respiratory syncytial virus (RSV) since Aug. 28.
“This is consistent activity for this time of the year,” the health minister said in a statement.
The end of August or the beginning of September has typically marked the beginning of flu season for provincial health authorities.
LaGrange also provided an update on the ongoing COVID-19 pandemic in the province.
From Aug. 28 to Sept. 8, there were a total 92 new hospitalizations and three ICU admissions, bringing the total to 417 in hospital and seven in ICU, a 73 per cent increase of COVID hospitalizations from the last reported info.
On July 24 – the last update to the province’s COVID data dashboard – there were only 242 in hospital.
“Sadly, five Albertans died during that period due to COVID-19,” LaGrange said.
LaGrange said the reporting dashboard is being refreshed to include RSV, influenza and COVID-19 data, work that was originally expected to be completed on Aug. 30. The latest data on the province’s influenza statistics dashboard is dated July 22.
“This work is currently underway and will be available in the coming weeks,” LaGrange said.
She said data for the dates between July 24 and Aug. 27 will be available when the new dashboard goes online.
Amid more hospitals continent-wide reinstating masking requirements in the face of increased hospitalizations, the health minister made no mention of any such moves for Alberta hospitals. Acute care COVID-19 outbreaks in Alberta jumped from Sept. 5 to 12, with 146 per cent more healthcare workers and 55 per cent more patients testing positive for COVID.
LaGrange stressed the “collective responsibility” to prevent the spread of airborne viruses like COVID and influenza.
“As a mother and grandmother, I understand the anxiety that comes with sending your children back to school. I want to reassure you that Alberta’s government has the health and well-being of all young Albertans top of mind,” the health minister said.
–with files from Meghan Cobb, Global News
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All Flesh Redux