Nitrous Oxide (N2O)

Informed consent, N2O% administered, length of sedation, flow rate, indication of use, patients response to N2O

What is required for N2O documentation

Analgesic and anxiolytic, rapid onset, wide safety margin, and quick recovery

What are the ideal characteristics for sedation

Low solubility in blood (rapid onset), excreted by lungs, no effect on HR and BP, crosses blood brain barrier and placenta

What are the characteristics of N2O

Anxiety/ fainting, gag reflex, angina, post MI, Post CVA, long procedure, inadequate local anesthesia

What are indications of N2O

Nasal obstruction, Vitamin B12 deficiency, Alcoholic/recovering addict, communication barrier, patients response refusal

What are absolute contraindication for N2O

Middle ear infection, balance disorder, motion sickness, claustrophobia, marijuana/hallucinogenic drug use

What are relative contraindications for N2O

Pulmonary disease, immunocompromised, pregnancy, psychiatric disorder/bipolar.

What relative contraindications for N2O require med consult

Nausea, dysphoria, dizziness, headache, hallucinations, mask claustrophobia, urinary incontinence, increased apprehension

What are side effect to N2O

Headache

What side effect of N2O is caused by technique

Bone marrow suppression, reproductive disturbance, neurological deficits, possible hepatotoxicity

What are the effects from long term exposure of N2O

O2-green and N2O blue

What color are the O2 and N2O tankS

Mechanism that shuts off the equipment if O2 less than 30%

What is the O2 fail safe mechanism

Mechanism that allows rapid administration of O2

What is the flush button

The flush button

What mechanism is used to treat over sedation

90-95% liquid and 5% gas (top layer)

How is N2O stored

750 psi

What pressure (psi) is displayed when liquid N2O is present in the tank

Pressure falls in relation to remaining gas

What pressure (psi) is displayed when gas N2O only remains in the tank

The pin holes for O2 and N2O are different to prevent accidental reversal

What is the pin index safety system

Mechanism that allows atmospheric air to flow in if gas flow stops

What is emergency air inlet

Nasal appliance that allows gas to reach nose and when exhaled removes air to a vacuum away from provider and patient

What is the scavenging hood

With 5-6L/min flow rate of 100% O2

How should N2O administration start

Gradually titrated in 10% intervals, watch for signs of sedation

How is N2O added during the administration of N2O

50%

What is the average percentage of N2O a patient receives

100% O2 for 5mins

How does N2O administration end

NO!

Can a patient be left unattended on N2O