RE: New Policy- Oxygen use by DCs

[Guest guest]

And yet...non-licensed, private citizens can own and operate "Oxygen Bars," which provide 40% oxygen, to the general public for non-medical purposes...

Does this ruling mean Chiropractors CAN'T own an oxygen bar as a private citizen?

Seems like our "license" sometimes provides us FEWER FREEDOMS than the general public possesses (i.e., prior Board rulings regarding magnets and multi-level marketing...). (:-)

New Policy- Oxygen use by DCs

Listserv members,

This is an announcement detailing a new policy that came about after a DC inquiry. You should also note the answer to another question posed: "Can a DC administer Oxygen prior to giving an adjustment?" The answer to that is NO. This is not considered an emergency situation. Please read the following notice and pass it along to any doctors you know that are not on this listserv. Please note that I am copying this to our executive director as required when I post policy statements as a board function.

Minga Guerrero DC

president OBCE

Oxygen In consideration of a licensee's request to use oxygen in an emergency situation, the Board adopted the following policy:

After some discussion the Board agreed to communicate to licensees that the Board of Medical Examiner rules state that providing oxygen in an emergency situation is NOT practicing medicine; therefore it is allowable for a chiropractic physician to use in medical emergencies.

Previously, the Board determined after consultation with the Board of Pharmacy, medical oxygen is on the Food and Drug Administration's list of drugs and substances which require a prescription. Based on this information, clearly medical oxygen is outside the chiropractic scope of practice and chiropractic physicians may not prescribe oxygen for a therapeutic purposes. (4/27/00)] 3/16/06

Oxygen in Emergencies

Chiropractic physicians may obtain oxygen units on an over-the-counter non- prescription basis provided a few basic requirements are met. Use of portable oxygen units for clinic emergencies is currently taught at Western States Chiropractic College. Access to emergency oxygen could be useful in the event of a cardiac arrest or other incident in which a patient may stop or have difficulty breathing. These OTC oxygen units are readily available over the Web from a variety of distributors.

According to the FDA, any oxygen inhaled by a human or animal is considered a drug as persection 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act), and is required to be dispensed by prescription. However, the agency allows medical oxygen to be dispensed without a prescription to properly trained individuals for oxygen deficiency and resuscitation, as long asthe following conditions are met:

1) A high-pressure cylinder filled with medical oxygen and used for oxygen deficiency and resuscitation must have the following statement present on the drug label: "For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx Only." 2) The equipment intended for such use must deliver a minimum flow rate of 6 liters of oxygen per minute for a minimum of 15 minutes, and include a content gauge and an appropriate mask or administration device, and 3) Proper training is documentation that an individual has received training within the past twenty-four months or other appropriate interval, in the use of emergency oxygen including providing oxygen to both breathing and non-breathing patients, and safe use and handing ofemergency oxygen equipment. Training may be obtained from any nationally recognized professional organization, such as the National Safety Council, the American Heart Association, the American Red Cross, etc. Under no circumstances can emergency oxygen be used to fillhigh-pressure cylinders or be used in a mixture or blend.

Once all of these conditions are met, an individual may have access to medical oxygen without a prescription. (11/16/06)

[Guest guest]

I guess I should have specified in this

post I sent yesterday that I’m really addressing it to Dave McTeague and

to Dr. Guerrera for their comments as the logic of this whole thing completely

escapes me. It wouldn’t be the first time I missed the point, so

any clarification of the thinking supporting this ruling, perhaps including

quotes from the documentation of the rationale behind the ruling would be much

appreciated.

S. Feinberg, D.C.

This is a little confusing. Does

this ruling mean:

1) That which is done on an emergency basis is not therapeutic?

If so, how so? What does an “emergency basis” mean? Is

this not a situation in which the requirement for therapeutic intervention is

considered so critical that that application of such therapeutic intervention

is not optional? By what logic is a therapy provided on an emergency

basis not therapeutic and if it is therapeutic, then how does the Board support

their previous ruling in this matter. Are there notes kept in which such

deliberation is described?

2) What is the logic in assuming that what is legal in an emergency

situation should not be appropriate and legal in non-emergency situation.

3) I assume that the emergency nature of a patient’s condition is

not the only issue and that the use of oxygen is appropriate to a chiropractic

practice in a way that performing an emergency craniotomy would not be.

Or is it?

S. Feinberg, D.C.

From:

[mailto: ] On Behalf

Of M. s, D.C.

Sent: Tuesday, December 05, 2006

11:44 AM

Subject: Re: New

Policy- Oxygen use by DCs

And yet...non-licensed, private citizens can own and

operate " Oxygen Bars, " which provide 40% oxygen, to

the general public for non-medical purposes...

Does this ruling mean Chiropractors CAN'T own an oxygen bar as a

private citizen?

Seems like our " license " sometimes provides us FEWER

FREEDOMS than the general public possesses (i.e., prior Board

rulings regarding magnets and multi-level marketing...). (:-)

New

Policy- Oxygen use by DCs

Listserv members,

This is an announcement detailing a new policy that came about after a

DC inquiry. You should also note the answer to another question posed: " Can

a DC administer Oxygen prior to giving an adjustment? " The answer to

that is NO. This is not considered an emergency situation. Please read the

following notice and pass it along to any doctors you know that are not on this

listserv. Please note that I am copying this to our executive director as

required when I post policy statements as a board function.

Minga Guerrero DC

president OBCE

Oxygen

In consideration of a licensee's request to use oxygen in an emergency

situation, the Board adopted the following policy:

After some discussion the Board agreed to communicate to licensees that

the Board of Medical Examiner rules state that providing oxygen in an emergency

situation is NOT practicing medicine; therefore it is allowable for a

chiropractic physician to use in medical emergencies.

Previously, the Board determined after consultation with the Board of

Pharmacy, medical oxygen is on the Food and Drug Administration's list of

drugs and substances which require a prescription. Based on this information,

clearly medical oxygen is outside the chiropractic scope of practice and

chiropractic physicians may not prescribe oxygen for a therapeutic purposes.

(4/27/00)] 3/16/06

Oxygen in Emergencies

Chiropractic physicians may obtain oxygen units on an over-the-counter

non- prescription basis provided a few basic requirements are met. Use of

portable oxygen units for clinic emergencies is currently taught at Western States Chiropractic

College. Access to

emergency oxygen could be useful in the event of a cardiac arrest or other

incident in which a patient may stop or have difficulty breathing. These

OTC oxygen units are readily available over the Web from a variety of

distributors.

According to the FDA, any oxygen inhaled by a human or animal is considered

a drug as per

section 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act), and is

required to be dispensed by prescription. However, the agency allows

medical oxygen to be dispensed without a prescription to properly trained

individuals for oxygen deficiency and resuscitation, as long as

the following conditions are met:

1) A high-pressure cylinder filled with medical oxygen and used for

oxygen deficiency and resuscitation must have the following statement present

on the drug label: " For emergency use only when administered by

properly trained personnel for oxygen deficiency and resuscitation. For

all other medical applications, Rx Only. "

2) The equipment intended for such use must deliver a minimum flow rate of 6

liters of oxygen per minute for a minimum of 15 minutes, and include a content

gauge and an appropriate mask or administration device, and

3) Proper training is documentation that an individual has received training

within the past twenty-four months or other appropriate interval, in the use of

emergency oxygen including providing oxygen to both breathing and non-breathing

patients, and safe use and handing of

emergency oxygen equipment. Training may be obtained from any nationally

recognized professional organization, such as the National Safety Council, the

American Heart Association, the American Red Cross, etc. Under no circumstances

can emergency oxygen be used to fill

high-pressure cylinders or be used in a mixture or blend.

Once all of these conditions are met, an individual may have access to

medical oxygen without a prescription. (11/16/06)

[Guest guest]

Les,

Dave is no longer on this listserv and will never see posts unless I/you sent it to him. The posts you see from Dave are made on his behalf. When Dave sees things that he thinks might interest the profession, he fwd to one of us who then posts on the listserv.

I have to admit that I am not reading all the listserv posts. I've been busy with OBCE business(cpmplaints), DR. Ron Rominick's OSAA issue, insurance edits from Stockton that are extremely alarming for the profession's financial survival, advertising rules recently proposed by a DC that require the board's rules advisory committe action, ETSDP (experimental tests devices and procedures)committee work on several pieces of equiptment area docs have inquired about and oh yeah, running my practice. The main reason for doing anything about the oxygen question was that a local DC asked us (OBCE) to please help with it. The DC wanted to purchase Oxygen and no vendors would sell it to them. Not the fault of the vendors. there was just a glitch in statute wording that prevented DCs from obtaining it. It required that the board get legal advice, consult with the pharmacy board, and other boards in Oregon and across the country to see if we could in fact help this DC with his intended goal. The rule is simply due to that inquiry and is the result of countless hours of work by Dave McTeague, Lori Lindley our assistant AG, board staff and members. There are other implications I'd be happy to discuss with you personally if you give me a call. Too much to type. I'm copying this to Dave so he knows what I've explained. Hope this is not a violation of the listserv. Please let me know if it is.

Minga Guerrero DC

In a message dated 12/6/2006 6:36:37 AM Pacific Standard Time, feinberg@... writes:

I guess I should have specified in this post I sent yesterday that I’m really addressing it to Dave McTeague and to Dr. Guerrera for their comments as the logic of this whole thing completely escapes me. It wouldn’t be the first time I missed the point, so any clarification of the thinking supporting this ruling, perhaps including quotes from the documentation of the rationale behind the ruling would be much appreciated.

S. Feinberg, D.C.

This is a little confusing. Does this ruling mean:

1) That which is done on an emergency basis is not therapeutic? If so, how so? What does an “emergency basis†mean? Is this not a situation in which the requirement for therapeutic intervention is considered so critical that that application of such therapeutic intervention is not optional? By what logic is a therapy provided on an emergency basis not therapeutic and if it is therapeutic, then how does the Board support their previous ruling in this matter. Are there notes kept in which such deliberation is described?

2) What is the logic in assuming that what is legal in an emergency situation should not be appropriate and legal in non-emergency situation.

3) I assume that the emergency nature of a patient’s condition is not the only issue and that the use of oxygen is appropriate to a chiropractic practice in a way that performing an emergency craniotomy would not be. Or is it?

S. Feinberg, D.C.

From: [mailto: ] On Behalf Of M. s, D.C.Sent: Tuesday, December 05, 2006 11:44 AM Subject: Re: New Policy- Oxygen use by DCs

And yet...non-licensed, private citizens can own and operate "Oxygen Bars," which provide 40% oxygen, to the general public for non-medical purposes...

Does this ruling mean Chiropractors CAN'T own an oxygen bar as a private citizen?

Seems like our "license" sometimes provides us FEWER FREEDOMS than the general public possesses (i.e., prior Board rulings regarding magnets and multi-level marketing...). (:-)

New Policy- Oxygen use by DCs

Listserv members,

This is an announcement detailing a new policy that came about after a DC inquiry. You should also note the answer to another question posed: "Can a DC administer Oxygen prior to giving an adjustment?" The answer to that is NO. This is not considered an emergency situation. Please read the following notice and pass it along to any doctors you know that are not on this listserv. Please note that I am copying this to our executive director as required when I post policy statements as a board function.

Minga Guerrero DC

president OBCE

Oxygen In consideration of a licensee's request to use oxygen in an emergency situation, the Board adopted the following policy:

After some discussion the Board agreed to communicate to licensees that the Board of Medical Examiner rules state that providing oxygen in an emergency situation is NOT practicing medicine; therefore it is allowable for a chiropractic physician to use in medical emergencies.

Previously, the Board determined after consultation with the Board of Pharmacy, medical oxygen is on the Food and Drug Administration's list of drugs and substances which require a prescription. Based on this information, clearly medical oxygen is outside the chiropractic scope of practice and chiropractic physicians may not prescribe oxygen for a therapeutic purposes. (4/27/00)] 3/16/06

Oxygen in Emergencies

Chiropractic physicians may obtain oxygen units on an over-the-counter non- prescription basis provided a few basic requirements are met. Use of portable oxygen units for clinic emergencies is currently taught at Western States Chiropractic College. Access to emergency oxygen could be useful in the event of a cardiac arrest or other incident in which a patient may stop or have difficulty breathing. These OTC oxygen units are readily available over the Web from a variety of distributors.

According to the FDA, any oxygen inhaled by a human or animal is considered a drug as persection 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act), and is required to be dispensed by prescription. However, the agency allows medical oxygen to be dispensed without a prescription to properly trained individuals for oxygen deficiency and resuscitation, as long asthe following conditions are met:

1) A high-pressure cylinder filled with medical oxygen and used for oxygen deficiency and resuscitation must have the following statement present on the drug label: "For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx Only." 2) The equipment intended for such use must deliver a minimum flow rate of 6 liters of oxygen per minute for a minimum of 15 minutes, and include a content gauge and an appropriate mask or administration device, and 3) Proper training is documentation that an individual has received training within the past twenty-four months or other appropriate interval, in the use of emergency oxygen including providing oxygen to both breathing and non-breathing patients, and safe use and handing ofemergency oxygen equipment. Training may be obtained from any nationally recognized professional organization, such as the National Safety Council, the American Heart Association, the American Red Cross, etc. Under no circumstances can emergency oxygen be used to fillhigh-pressure cylinders or be used in a mixture or blend.

Once all of these conditions are met, an individual may have access to medical oxygen without a prescription. (11/16/06)

[Guest guest]



I am personally very happy with this change. In the past we have used it in emergency cases, acute asthmatic attack, partial airway obstruction... A flight attendant and mountain climber could use O's, but a licensed physician couldn't. This didn't make sense. The rule change is appropriate. This also works in line with the ACA's goal of aligning us with disaster relief organizations as well as training received by sports chiropractors for on field emergency procedures. Thank you for the time and effort in this modification.

Ted

Ted Forcum, DC, DACBSP

ACA Sports Council, 2nd Vice PresidentBack In Motion Sports Injuries Clinic, LLC11385 SW Scholls Ferry RoadBeaverton, Oregon 97008

On Sat, 16 Dec 2006 18:18:53 EST AboWoman@... writes:

Les,

Dave is no longer on this listserv and will never see posts unless I/you sent it to him. The posts you see from Dave are made on his behalf. When Dave sees things that he thinks might interest the profession, he fwd to one of us who then posts on the listserv.

I have to admit that I am not reading all the listserv posts. I've been busy with OBCE business(cpmplaints), DR. Ron Rominick's OSAA issue, insurance edits from Stockton that are extremely alarming for the profession's financial survival, advertising rules recently proposed by a DC that require the board's rules advisory committe action, ETSDP (experimental tests devices and procedures)committee work on several pieces of equiptment area docs have inquired about and oh yeah, running my practice. The main reason for doing anything about the oxygen question was that a local DC asked us (OBCE) to please help with it. The DC wanted to purchase Oxygen and no vendors would sell it to them. Not the fault of the vendors. there was just a glitch in statute wording that prevented DCs from obtaining it. It required that the board get legal advice, consult with the pharmacy board, and other boards in Oregon and across the country to see if we could in fact help this DC with his intended goal. The rule is simply due to that inquiry and is the result of countless hours of work by Dave McTeague, Lori Lindley our assistant AG, board staff and members. There are other implications I'd be happy to discuss with you personally if you give me a call. Too much to type. I'm copying this to Dave so he knows what I've explained. Hope this is not a violation of the listserv. Please let me know if it is.

Minga Guerrero DC

In a message dated 12/6/2006 6:36:37 AM Pacific Standard Time, feinberg@... writes:

I guess I should have specified in this post I sent yesterday that I’m really addressing it to Dave McTeague and to Dr. Guerrera for their comments as the logic of this whole thing completely escapes me. It wouldn’t be the first time I missed the point, so any clarification of the thinking supporting this ruling, perhaps including quotes from the documentation of the rationale behind the ruling would be much appreciated.

S. Feinberg, D.C.

This is a little confusing. Does this ruling mean:

1) That which is done on an emergency basis is not therapeutic? If so, how so? What does an “emergency basis†mean? Is this not a situation in which the requirement for therapeutic intervention is considered so critical that that application of such therapeutic intervention is not optional? By what logic is a therapy provided on an emergency basis not therapeutic and if it is therapeutic, then how does the Board support their previous ruling in this matter. Are there notes kept in which such deliberation is described?

2) What is the logic in assuming that what is legal in an emergency situation should not be appropriate and legal in non-emergency situation.

3) I assume that the emergency nature of a patient’s condition is not the only issue and that the use of oxygen is appropriate to a chiropractic practice in a way that performing an emergency craniotomy would not be. Or is it?

S. Feinberg, D.C.

From: [mailto: ] On Behalf Of M. s, D.C.Sent: Tuesday, December 05, 2006 11:44 AM Subject: Re: New Policy- Oxygen use by DCs

And yet...non-licensed, private citizens can own and operate "Oxygen Bars," which provide 40% oxygen, to the general public for non-medical purposes...

Does this ruling mean Chiropractors CAN'T own an oxygen bar as a private citizen?

Seems like our "license" sometimes provides us FEWER FREEDOMS than the general public possesses (i.e., prior Board rulings regarding magnets and multi-level marketing...). (:-)

New Policy- Oxygen use by DCs

Listserv members,

This is an announcement detailing a new policy that came about after a DC inquiry. You should also note the answer to another question posed: "Can a DC administer Oxygen prior to giving an adjustment?" The answer to that is NO. This is not considered an emergency situation. Please read the following notice and pass it along to any doctors you know that are not on this listserv. Please note that I am copying this to our executive director as required when I post policy statements as a board function.

Minga Guerrero DC

president OBCE

Oxygen In consideration of a licensee's request to use oxygen in an emergency situation, the Board adopted the following policy:

After some discussion the Board agreed to communicate to licensees that the Board of Medical Examiner rules state that providing oxygen in an emergency situation is NOT practicing medicine; therefore it is allowable for a chiropractic physician to use in medical emergencies.

Previously, the Board determined after consultation with the Board of Pharmacy, medical oxygen is on the Food and Drug Administration's list of drugs and substances which require a prescription. Based on this information, clearly medical oxygen is outside the chiropractic scope of practice and chiropractic physicians may not prescribe oxygen for a therapeutic purposes. (4/27/00)] 3/16/06

Oxygen in Emergencies

Chiropractic physicians may obtain oxygen units on an over-the-counter non- prescription basis provided a few basic requirements are met. Use of portable oxygen units for clinic emergencies is currently taught at Western States Chiropractic College. Access to emergency oxygen could be useful in the event of a cardiac arrest or other incident in which a patient may stop or have difficulty breathing. These OTC oxygen units are readily available over the Web from a variety of distributors.

According to the FDA, any oxygen inhaled by a human or animal is considered a drug as persection 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act), and is required to be dispensed by prescription. However, the agency allows medical oxygen to be dispensed without a prescription to properly trained individuals for oxygen deficiency and resuscitation, as long asthe following conditions are met:

1) A high-pressure cylinder filled with medical oxygen and used for oxygen deficiency and resuscitation must have the following statement present on the drug label: "For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx Only." 2) The equipment intended for such use must deliver a minimum flow rate of 6 liters of oxygen per minute for a minimum of 15 minutes, and include a content gauge and an appropriate mask or administration device, and 3) Proper training is documentation that an individual has received training within the past twenty-four months or other appropriate interval, in the use of emergency oxygen including providing oxygen to both breathing and non-breathing patients, and safe use and handing ofemergency oxygen equipment. Training may be obtained from any nationally recognized professional organization, such as the National Safety Council, the American Heart Association, the American Red Cross, etc. Under no circumstances can emergency oxygen be used to fillhigh-pressure cylinders or be used in a mixture or blend.

Once all of these conditions are met, an individual may have access to medical oxygen without a prescription. (11/16/06)

[Guest guest]

Ted,

thanks so much for the encouragement. I'll pass it on to Dave. Not by copying this, just verbally as per our rules.

Minga

In a message dated 12/16/2006 8:13:05 PM Pacific Standard Time, tlf-3@... writes:

 I am personally very happy with this change. In the past we have used it in emergency cases, acute asthmatic attack, partial airway obstruction... A flight attendant and mountain climber could use O's, but a licensed physician couldn't. This didn't make sense. The rule change is appropriate. This also works in line with the ACA's goal of aligning us with disaster relief organizations as well as training received by sports chiropractors for on field emergency procedures. Thank you for the time and effort in this modification.

Ted

Ted Forcum, DC, DACBSP

ACA Sports Council, 2nd Vice PresidentBack In Motion Sports Injuries Clinic, LLC11385 SW Scholls Ferry RoadBeaverton, Oregon 97008

On Sat, 16 Dec 2006 18:18:53 EST AboWomanaol writes:

Les,

Dave is no longer on this listserv and will never see posts unless I/you sent it to him. The posts you see from Dave are made on his behalf. When Dave sees things that he thinks might interest the profession, he fwd to one of us who then posts on the listserv.

I have to admit that I am not reading all the listserv posts. I've been busy with OBCE business(cpmplaints), DR. Ron Rominick's OSAA issue, insurance edits from Stockton that are extremely alarming for the profession's financial survival, advertising rules recently proposed by a DC that require the board's rules advisory committe action, ETSDP (experimental tests devices and procedures)committee work on several pieces of equiptment area docs have inquired about and oh yeah, running my practice. The main reason for doing anything about the oxygen question was that a local DC asked us (OBCE) to please help with it. The DC wanted to purchase Oxygen and no vendors would sell it to them. Not the fault of the vendors. there was just a glitch in statute wording that prevented DCs from obtaining it. It required that the board get legal advice, consult with the pharmacy board, and other boards in Oregon and across the country to see if we could in fact help this DC with his intended goal. The rule is simply due to that inquiry and is the result of countless hours of work by Dave McTeague, Lori Lindley our assistant AG, board staff and members. There are other implications I'd be happy to discuss with you personally if you give me a call. Too much to type. I'm copying this to Dave so he knows what I've explained. Hope this is not a violation of the listserv. Please let me know if it is.

Minga Guerrero DC

In a message dated 12/6/2006 6:36:37 AM Pacific Standard Time, feinbergeoni writes:

I guess I should have specified in this post I sent yesterday that I’m really addressing it to Dave McTeague and to Dr. Guerrera for their comments as the logic of this whole thing completely escapes me. It wouldn’t be the first time I missed the point, so any clarification of the thinking supporting this ruling, perhaps including quotes from the documentation of the rationale behind the ruling would be much appreciated.

S. Feinberg, D.C.

This is a little confusing. Does this ruling mean:

1) That which is done on an emergency basis is not therapeutic? If so, how so? What does an “emergency basis†mean? Is this not a situation in which the requirement for therapeutic intervention is considered so critical that that application of such therapeutic intervention is not optional? By what logic is a therapy provided on an emergency basis not therapeutic and if it is therapeutic, then how does the Board support their previous ruling in this matter. Are there notes kept in which such deliberation is described?

2) What is the logic in assuming that what is legal in an emergency situation should not be appropriate and legal in non-emergency situation.

3) I assume that the emergency nature of a patient’s condition is not the only issue and that the use of oxygen is appropriate to a chiropractic practice in a way that performing an emergency craniotomy would not be. Or is it?

S. Feinberg, D.C.

From: [mailto: ] On Behalf Of M. s, D.C.Sent: Tuesday, December 05, 2006 11:44 AM Subject: Re: New Policy- Oxygen use by DCs

And yet...non-licensed, private citizens can own and operate "Oxygen Bars," which provide 40% oxygen, to the general public for non-medical purposes...

Does this ruling mean Chiropractors CAN'T own an oxygen bar as a private citizen?

Seems like our "license" sometimes provides us FEWER FREEDOMS than the general public possesses (i.e., prior Board rulings regarding magnets and multi-level marketing...). (:-)

New Policy- Oxygen use by DCs

Listserv members,

This is an announcement detailing a new policy that came about after a DC inquiry. You should also note the answer to another question posed: "Can a DC administer Oxygen prior to giving an adjustment?" The answer to that is NO. This is not considered an emergency situation. Please read the following notice and pass it along to any doctors you know that are not on this listserv. Please note that I am copying this to our executive director as required when I post policy statements as a board function.

Minga Guerrero DC

president OBCE

Oxygen In consideration of a licensee's request to use oxygen in an emergency situation, the Board adopted the following policy:

After some discussion the Board agreed to communicate to licensees that the Board of Medical Examiner rules state that providing oxygen in an emergency situation is NOT practicing medicine; therefore it is allowable for a chiropractic physician to use in medical emergencies.

Previously, the Board determined after consultation with the Board of Pharmacy, medical oxygen is on the Food and Drug Administration's list of drugs and substances which require a prescription. Based on this information, clearly medical oxygen is outside the chiropractic scope of practice and chiropractic physicians may not prescribe oxygen for a therapeutic purposes. (4/27/00)] 3/16/06

Oxygen in Emergencies

Chiropractic physicians may obtain oxygen units on an over-the-counter non- prescription basis provided a few basic requirements are met. Use of portable oxygen units for clinic emergencies is currently taught at Western States Chiropractic College. Access to emergency oxygen could be useful in the event of a cardiac arrest or other incident in which a patient may stop or have difficulty breathing. These OTC oxygen units are readily available over the Web from a variety of distributors.

According to the FDA, any oxygen inhaled by a human or animal is considered a drug as persection 201(g)(1) of the Federal Food, Drug, and Cosmetic Act (the Act), and is required to be dispensed by prescription. However, the agency allows medical oxygen to be dispensed without a prescription to properly trained individuals for oxygen deficiency and resuscitation, as long asthe following conditions are met:

1) A high-pressure cylinder filled with medical oxygen and used for oxygen deficiency and resuscitation must have the following statement present on the drug label: "For emergency use only when administered by properly trained personnel for oxygen deficiency and resuscitation. For all other medical applications, Rx Only." 2) The equipment intended for such use must deliver a minimum flow rate of 6 liters of oxygen per minute for a minimum of 15 minutes, and include a content gauge and an appropriate mask or administration device, and 3) Proper training is documentation that an individual has received training within the past twenty-four months or other appropriate interval, in the use of emergency oxygen including providing oxygen to both breathing and non-breathing patients, and safe use and handing ofemergency oxygen equipment. Training may be obtained from any nationally recognized professional organization, such as the National Safety Council, the American Heart Association, the American Red Cross, etc. Under no circumstances can emergency oxygen be used to fillhigh-pressure cylinders or be used in a mixture or blend.

Once all of these conditions are met, an individual may have access to medical oxygen without a prescription. (11/16/06)

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