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Dental Nurse Sedation Post Qual Exam > Inhalation Sedation > Flashcards

Inhalation Sedation Flashcards

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1
Q

What are the aims of inhalation sedation?

A

Anxiolysis (reduces fear/anxiety) & analgesia (reduce pain)
Also to improve cooperation

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2
Q

What does Anxiolysis mean?

A

Reduce fear/anxiety

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3
Q

What does analgesia mean?

A

Reduces pain

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4
Q

How much heavier than air is nitrous oxide?

A

1.5

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5
Q

What coloured cylinders is nitrous oxide supplied in?

A

Blue

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6
Q

What size do nitrous oxide cylinders come in?

A

Size E

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7
Q

What pressure is nitrous oxide stored a liquid under?

A

44bar or750PSI

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8
Q

What are the properties of Nitrous Oxide?

A

Colourless and virtually odourless

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9
Q

How heavy is a full cylinder of Nitrous Oxide?

A

20lbs

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9
Q

How much Nitrous Oxide is needed to produce unconsciousness?

A

70%

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9
Q

What coloured cylinders is Oxygen supplied in?

A

Black with a white shoulder / by 2025 they will all covert to white bodies and carry the name oxygen on them

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10
Q

What pressure is oxygen stored a liquid under?

A

137bar or 2000 psi

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10
Q

What does MAC stand for?

A

minimum alveolar concentration

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11
Q

When referring to gases what does MAC relate to?

A

Potency (strength)

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12
Q

What is the time weighted average (TWA) for staff working with nitrous oxide?

A

100ppm over an 8 hour time period.

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13
Q

What does a half full nitrous oxide cylinder contain?

A

Gas above a liquid

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14
Q

What does a full oxygen cylinder contain?

A

Gas

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15
Q

Who has the legal responsibility for checking the inhalation sedation machine?

A

The treating clinician

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16
Q

Gases used for sedation have a relatively high MAC. What is it?

A

105

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17
Q

The MAC being “high” means that nitrous oxide is?

A

A weak anesthetic

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18
Q

Why is it virtually impossible to produce anaesthesia using nitrous oxide alone in a patient who is adequately oxygenated?

A

The MAC is over 80

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19
Q

At what concentration of nitrous oxide is plane 1 obtained?

A

5-25%

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20
Q

What is the seal called on the oxygen cylinder?

A

Bodok seal

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21
Q

At what concentration of nitrous oxide is plane 2 obtained?

A

20-55%

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22
Q

At what concentration of nitrous oxide is plane 3 obtained?

A

Above 50%

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23
Q

What is plane 1 of analgesia?

A

Moderate sedation and analgesia
Relaxation
Tingling in fingers, toes n cheeks
Warmth
Alert and responsive
Pulse/Bp will be normal

24
Q

What is plane 2 of analgesia?

A

Dissociation sedation and analgesia
Relaxation/ sleepiness
Possible dreaming
Delayed response to questioning

25
Q

What is plane 3 of analgesia?

A

Total analgesia
Marked sleepiness and glazed appearance
Nausea and dizziness
Vomiting
Unresponsive to questioning

26
Q

What is sickle cell disease?

A

Blood disease, abnormal form of hemoglobin

27
Q

What does inhalation sedation improve?

A

Gagging

28
Q

In what trimester can inhalation sedation not be used?

A

1st trimester

29
Q

What is the rapid onset of inhalation sedation?

A

2-3 minutes - peak: 3-5

30
Q

What is the rapid recovery of inhalation sedation?

A

3-5 minutes

31
Q

Are electromechanical monitoring mandatory for inhalation sedation?

A

No

32
Q

Contraindications of inhalation sedation?

A

Nasal obstruction
Claustrophobic patients
ASA 3+
Muscle wasting disease (myasthenia Gravis /multiple sclerosis)

33
Q

Indications of inhalation sedation?

A

Anxiety
Needle phobia
Pain control
Allergic to IV agents
Gagging
Pt at risks of respiratory depression - asthma/Sickle cell anaemia

34
Q

Why do Sickle cell anaemia and asthma patients benefit from IHS other than IV sedation?

A

Benefit from a guaranteed oxygen level of at least 30%

35
Q

What is sickle cell anaemia?

A

Lack of oxygen in the haemoglobin

36
Q

Why would an asthma patient be more likely to have ihs instead of IV?

A

To avoid respiratory depressive effect. And they will benefit from increased level of oxygen

37
Q

Why would somebody who is diabetic benefit from IHS more than GA?

A

GA has longer period of starvation

38
Q

Why would somebody with kidney/ liver disease be treated with RA rather than IV or GA?

A

Drug is not metabolised in the liver

39
Q

Why would somebody with cerebral palsy benefit from IHS?

A

Reduces involuntary movements

40
Q

What does PSI stand for?

A

Pound per square inch

41
Q

What is the quantiflex MDM head?

A

The inhalation machine

42
Q

What on the RA machine is used to titrate the nitrous oxide?

A

the mixture dial

43
Q

What is the tube on the left of the RA machine showing?

A

N20

43
Q

What controls the flow rate?

A

Flow control valve

43
Q

What is the tube on the right of the RA machine showing?

A

O2

44
Q

How can you inflate the bag without setting the flow rate?

A

o2 flush button

45
Q

How can you check the reservoir bag has no holes?

A

Cover the non-rebreathing check valve with hand and inflate bag with o2 flush button.
Inspect the bag

46
Q

How often should the bodok seal be changed?

A

2 years

47
Q

What are the safety checks on the RA machine?

A

Oxygen fail safe
oxygen flush
Reservoir bag
Minimum oxygen 30%
Check inlet valve isn’t blocked

48
Q

what is the Air entrainment valve ?

A

Would operate if the patient was in spontaneous respiration and there was an obstruction in the fresh gas to the patient

49
Q

What is the scavenging system?

A

Vacuum suction

50
Q

How should Size C, D and E cylinders be stored?

A

Horizontally on shelves

51
Q

How should Size F, G and J cylinders be stored?

A

Vertically on concrete floor pens

52
Q

Does Nitrous oxide bind to components of the blood like oxygen?

A

No it is carried in the blood

53
Q

Whys is there a rapid recovery from nitrous oxide?

A

It has a poor solubility

54
Q

What is diffusion hypoxia?

A

Due to the sudden reversal of concentration gradients in the lungs following the discontinuation of nitrous oxide, leading to a decrease in oxygen levels in the bloodstream

55
Q

How can we avoid diffusion hypoxia?

A

Give 2 minutes of oxygen after tx is finished

56
Q

How long does it take for the patient to feel the initial effect of nitrous oxide?

A

after 20 seconds

57
Q

How long does it take for the patient to feel the full effect of nitrous oxide?

A

3-5 mins

58
Q

Where does the nitrous oxide is inhaled, where does it travel to?

A

Alveoli sacs within the lungs

59
Q

When Nitrous oxide is introduced to the body, how does it get into the blood?

A

It diffuses through the alveolar membrane into the blood

Dental Nurse Sedation Post Qual Exam (11 decks)

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