Inhalation Sedation

Question 1

what are the indications for IS

Answer 1

anxiety
needle phobia
gagging
traumatic procedures
medical

Question 2

what are the contraindications for IS

Answer 2

common cold
tonsillar enlargement
severe COPD
first trimester pregnancy
fear of mask/claustrophobia
patients with limited ability to understand

Question 3

what are the safety features of IS

Answer 3

air entrainment valve
oxygen flush button
reservoir bag
colour coding
scavenging system
oxygen and nitrous oxide pressure dials
pressure reducing valves
one way expiratory valve
quick fit connection for positive pressure oxygen delivery

Question 4

what are the advantages of IS

Answer 4

rapid onset
rapid peak action
depth altered either way
flexible duration
rapid recovery
no injection for sedation
few side effects to patient
drug not metabolised
some analgesia
no amnesia

Question 5

what are the disadvantages of IS

Answer 5

equipment expensive
gases expensive
space occupying equipment
not potent
requires ability to breathe through nose
chronic exposure risk
staff addition
difficult to accurately determine actual dose

Question 6

what are the signs of adequate sedation

Answer 6

patient relaxed/comfortable
patient awake
reduced blink rate
laryngeal reflexes unaffected
vital signs unaffected
gag reflex reduced
mouth open on request
decreased reaction to painful stimuli
decrease in spontaneous movements
verbal contact maintained

Question 7

what are the symptoms of adequate sedation

Answer 7

mental and physical relaxation
lessened awareness of pain
paraesthesia
lethargy
euphoria
detachment
warmth
altered awareness of passage of time
dreaming
small controllable fit of giggles

Question 8

what are the signs and symptoms of over sedation

Answer 8

repeated mouth closing
spontaneous mouth breathing
nausea vomiting
irrational and sluggish responses
decreased cooperation
incoherent speech
uncontrolled laughter
patient no longer enjoying effects
LOC

Question 9

what are the pre-operative instructions for IS

Answer 9

have light meal before
take routine medicines normally
accompanied by competent adult
do not drink alcohol on day
wear sensible clothing
arrange care of children
plan to remain up to 30 mins after treatment

Question 10

outline the procedure for IS

Answer 10

place nasal hood on child
start O2 flow at 5-6l/min
gradually put the O2 down to 80% and then reduce by 5% per minute and then stop when the patient feels ready for treatment
constantly reassure and give hypnotic suggestion

Question 11

what do you do if the patient is oversedated

Answer 11

increase O2 in 5-10% increments until satisfactory

Question 12

what is recovery like for IS

Answer 12

gradually increase O2 by 10-20% per minute until 100% or can turn straight to 100%
administer 100% O2 for 2-3mins to prevent diffusion hypoxia
remove hood and turn gas flow off