PM wk 3 nitrous

Nitrous sedation is

Inhalation sedation

Admitted W/ 02

Absorbed/elimnated from lungs by diffusion

Exerts (what it helps with med term)

Analgesic (May involve spinal neuromodulators), anxiolytic (May involve GABA receptors)

Works by

↑ pain threshold (not altering PNS)

Advantages

Fast onset/recovery (<20 sec, peak @3-5min)

Titration

Use on variety of med compromised (bc no main adverse)

No allergies

Not changed in body

Disadvantages

•Cost, 5% pt doesn't work, chronic ↑ level exposure can cause disorders (reproductive, blood, immune, kidney, liver)

Contraindications big deal

COPD

Confined air space (ear/eye surgery recently, bowel obstruction)

W/ need= psychosis

Latex allergy

Contraindications considerations

Coughing

Mouth breather

Substance abuse

CNS depressant use

Ear infection

Claustrophobia

Minimal to no food 2hrs prior

Asa ¾ = med consult

Side effects

Nausea/vomit

Hallucinate (never leave pt alone)

↓ BP / breaths

Shiver

Faint

Green tank

02 100% gas

Reads full @ 2200 psi only when full

Blue tank

N20 95% liquid 5% gas

reads full @ 745 until all liquid has evaporated

Calculations

% N20 = Lpm N20 / total flow (Lpm 02 + L pm N20)

% O2 = Lpm O2 / total flow (Lpm 02 + L pm N20)

Admin steps

Pt assessment and informed consent (ADRA) → presedation phase → induction/monitoring → recovery → documentation

Presedation phase

Start 02 @ flow of 5 (child) - 7Lpm → seal mask on pt → bag should not be over/under inflated but moving w/ breaths

Induction/monitoring

10% N20 for 1min @ pre flow rate → no sedation =î 20% for 1 min → 5% ↑ every min till desired effect → 3 nose breaths if not working → 5% PPI doesn't work

Do not exceed 50% N20 (clinic)

Recovery

02 flush (100% 02 for >5min) → reassess vitals