Inhalation Sedation

Question 1

Contraindications for Inhalation Sedation

Answer 1

Common cold
Tonsillar/ adenoidal enlargement
Severe COPD
First trimester of pregnancy
Fear of “mask”/ claustrophobia
Patients with limited ability to understand

Question 2

Indications for I.S.?

Answer 2

Anxiety
Needle phobia
Gagging
Traumatic procedures
Medical conditions aggravated by stress
Unaccompanied adults requiring sedation

Question 3

What is a scavenging system?

Answer 3

Medical device used in hospitals. It is used to gather gas or aerosolized medication after it is exhaled from the patient.

Question 4

How many changes of room air per hour is required when doing IS?

Answer 4

15 changes of air per hour.

Question 5

Why is it important to ensure patient does not mouth breathe during IS?

Answer 5

If they mouth breathe, they will expel the nitrous oxide gas into the atmosphere, and put others in room at risk.

Question 6

Advantages of IS?

Answer 6

Rapid onset: 2-3 minutes
Rapid peak action
Flexible duration
Rapid recovery (once you turn off nitrous oxide)
Drug NOT metabolised
No injection required for sedation
Few side effects to patient
No amnesia

Question 7

Disadvantages of IS?

Answer 7

Expensive
Space occupying equipment
Requires ability to breath through nose
Chronic exposure risk?
Staff addiction
Difficult to accurately determine actual dose.

Question 8

Signs of adequate sedation?

Answer 8

Pt. relaxed/ comfortable
Pt. awake
Reduced blink rate
Laryngeal reflexes unaffected
Vital signs unaffected
Gag reflex obtunded
Mouth open on request
Decreased reaction to painful stimuli
Decrease in spontaneous movements
Verbal contact maintained

Question 9

Signs and symptoms of over-sedation?

Answer 9

Mouth closing - repeatedly
Spontaneous mouth breathing
Nausea/ vomiting
Irrational and sluggish responses
Decreased co-operation
Incoherent speech
Uncontrolled laughter
Patient no longer enjoying effects

Question 10

What is flow of gas in IS?

Answer 10

5-6l per minute