Inhalation Sedation Flashcards
What are some indications for inhalation sedation?
- anxiety
- needle phobia
- gagging
- traumatic procedures
- medical conditions aggravated by stress
- unaccompanied adults requiring sedation
what are some contraindications for inhalation sedation?
- common cold / snotty
- tonsillar / adenoidal enlargement
- severe COPD
- first trimester of pregnancy
- fear of mask / claustrophobia
- patients with limited ability to understand
What equipment is needed for inhalation sedation?
- gas cylinders
- pressure reducing valves
- flow control meter
- reservoir bag
- gas delivery hoses
- nasal hood
- waste gas scavenging system
What volume does the reservoir bag hold?
2 or 3 litres
what is delivered via the gas delivery hoses?
- one hose delivers fresh gasses from machine
- other hose delivers waste gas to scavenging system
what can you do to reduce the likelihood of mouth breathing occurring during inhalation sedation?
- use of rubber dam
- check mask seal
what are some advantages of inhalation sedation?
- rapid onset
- rapid peak action
- depth altered either way
- flexible duration
- rapid recovery
- no injection
- few side effects
- drug not metabolised
- some analgesia
- no amnesia
what are some disadvantages of inhalation sedation?
- equipment expensive
- gasses expensive
- space occupying equipment
- not potent
- requires ability to breathe through nose
- chronic exposure risk
- staff addiction
- difficult to determine dose
what are some signs of adequate sedation?
- patient relaxed/comfortable
- patient awake
- reduced blink rate
- laryngeal reflexes unaffected
- vital signs unaffected
- gag reflux obtunded
- decreased reaction to painful stimuli
- decreased spontaneous movement
- verbal contact maintained
what are some symptoms of adequate sedation?
- mental & physical relaxation
- lessened awareness of pain
- paraesthesia
- lethargy
- detachment
- euphoria
- warmth
- altered awareness of passage of time
- dreaming
- giggles
what are some signs & symptoms of over-sedation?
- mouth closing
- spontaneous mouth breathing
- nausea/vomiting
- irrational and sluggish responses
- incoherent speech
- uncontrolled laughter & tears
- patient feeling sick
- LOC
what pre-operative instructions would you give to a patient getting inhalation sedation?
- have a light meal before appt
- take routine meds as usual
- children accompanied by a competent adult
- do not drink alcohol on day of appt
- wear sensible clothing
- plan to remain in clinic for up to 30 mins after procedure
What are the steps of setting up for inhalation sedation?
- set up machine
- select nasal hood
- connect to hoses
- set mixture dial to 100% oxygen
- settle patient in dental chair
- reinforce explanation of expectations (breathing through nose)
- place hood on patients nose
What should the flow meter be set to for inhalation sedation?
5-6l per minute
what would you do if the reservoir bag is only moving very slightly during inhalation sedation?
check seal & look for mouth breathing +- decrease the flow
