Inhalation sedation

Question 1

Indications for Inh sedation

Answer 1

• anxiety
• gag reflex
• needle phobia
• traumatic procedure
• medical conditions aggrevated by stress
• unaccompanied adults requiring sedation

Question 2

Contraindications for Inh sedation

Answer 2

• common cold
• severe COPD
• tonsillar / adenoidal enlargement
• first trimester of pregnancy
• fear of mask/claustraphobia
• limited understanding of ‘breathing through nose’

Question 3

Purpose of a reservior bag

Answer 3

-monitor respiration

Question 4

Purpose of a scavenging system

Answer 4

-scavenges waste gas

Question 5

Safety features of Inh sedation

Answer 5

• pin index system: prevent wrong cylinder insertion
• diameter index system: prevent pipe cross/contam
• minimum oxygen delivery: 30%
• oxygen failsafe: occurs when oxygen <40psi
• colour coding
• oxygen flush & monitor
• reservoir bag
• scavenging system
• one way expiratory valve

Question 6

Advantages to IS sedation

Answer 6

• rapid onset (2-3mins)
• rapid peak action (3-5mins)
• depth can be altered either way
• flexible duration
• rapid recovery
• few side affects
• drug NOT metabolised
• no amnesia

Question 7

Disadvantages to IS sedation

Answer 7

• expensive equipment
• gases expensive
• not potent
• requires ability to breathe through nose
• chronic exposure risk?
• difficult to measure dose?

Question 8

SIGNS of adequate sedation

Answer 8

• Patient relaxed/comfortable
• Patient 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

SYMPS of adequate sedation

Answer 9

• Mental and physical relaxation
• Lessened awareness of pain
• Paraesthesia – lips, fingers, toes, legs, tongue
• Lethargy/”a few pints”, “why your mum is less grumpy after a glass
of wine”
• Euphoria
• Detachment ‘floating feeling’
• Warmth
• Altered awareness of passage of time
• Dreaming
• Small controllable “fit of the giggles”

Question 10

SIGNS of OVERsedation

Answer 10

• Mouth closing – repeatedly
• Spontaneous mouth breathing
• Nausea/vomiting
• Irrational and sluggish responses
• Decreased cooperation
• Incoherent speech
• Uncontrolled laughter, tears
• Patient no longer enjoying the effects
• LOC