Inhalational Sedation

Question 1

What are the indications for inhalational sedation?

Answer 1

anxiety
needle phobic
Gaging
Traumatic experience
Medical conditions that are aggravated by stress
Unaccompanied adults that require sedation

Question 2

What are the contraindications to inhaltional sedation?

Answer 2

Cold
Tonsillar/adenoid enlargement
severe COPD
First trimester preganancy
Claustrophobic
Patients with a limited ability to understand

Question 3

What equipment is needed for inhalational sedation?

Answer 3

Gas cylinders
Pressure reeducing  valve
Flow control meter
Resevoir bag
Gas delivery hoses
Nasal Hood
Waste gas scavenger system

Question 4

What pressure are the oxygen cylinders kept at?

Answer 4

1900psi

Question 5

What colour are the oxygen cylinders?

Answer 5

Black with a white collar

Question 6

What pressire are the NO cylinders kept at?

Answer 6

750psi

Question 7

What colour are the NO cylinders?

Answer 7

Blue

Question 8

When does the pressire guage for oxygen begin to fall and how does this differ for NO?

Answer 8

For Oxygen the guage starts to fall as soon as oxygen is used. for NO the guage stays constant until only 1/8 of the contents is left since NO is a liquid and the liquid vapourises keeping the pressure constant

Question 9

what is the purpose of the pressure reducing valve?

Answer 9

this reduces the pressure to 45psi so pt can breathe easily

Question 10

When using the flow control meter where is the reading taken from in relation to the ball?

Answer 10

it is taken from the equator of the ball

Question 11

How accurate is the ball and flow meter?

Answer 11

5% plus or minus

Question 12

What colour is the NO flow meter?

Answer 12

Blue

Question 13

What is used to attach the oxygen cylinder to the yolk of the machine?

Answer 13

Pin index system which is unique to oxygen

Question 14

What is there between the oxygen cylinder and the sedation machine?

Answer 14

A bodock seal

Question 15

T/F the NO cylinder also has a Bodock seal?

Answer 15

T

Question 16

What does the oxygen flow meter read?

Answer 16

Measures flow of oxygen up to 10l per min

Question 17

What does the nitrous oxygen flow meter read?

Answer 17

Flow rate of up to 10l per min

Question 18

What is the purpose of the air entrainment valve?

Answer 18

If gases fail then this valve enables room air to go into circuit

Question 19

What is the purpose of the oxygen flush button?

Answer 19

This flushes 35l oxygen per minute and used in emergencies

Question 20

What is the resevoir bag made from?

Answer 20

Silicone

Question 21

How many litres can the resevoir bag hold?

Answer 21

2-3

Question 22

What is the purpose of the oxygen resevoir bag?

Answer 22

It enables you to monitor respiration as it moves with respiration and it mustn’t collapse

Question 23

What is the structure of the delivery hoses?

Answer 23

Corrugated 2.5cm diameter with universal joins

Question 24

What is the purpose of having two hoses?

Answer 24

One hose delivers fresh gas

The other house takes away waste gas

Question 25

What feature is incorporated in the expired gas hose?

Answer 25

A non return valve

Question 26

T/F the scavenging system has a negative pressure?

Answer 26

True

A slight negative pressure

Question 27

How does the scavenger system work?

Answer 27

It changes the surgery air 14 times per hour

Question 28

How can you reduce contamination from NO?

Answer 28

Check mask correct size and check if patient is mouth breathing

Question 29

What are the safety features incorporated into inhalational equipment?

Answer 29

Pin index system: prevents wrong cylinder from being attached
Diameter index: hoses can only be attached on to oxygen or NO nt both 
Min Oxygen: 30%
Oxygen fail safe: operates when oxygen is less then 40psi
Air entrainment valve
Oxygen flush button 
Colour coding
Scavenger 
Pressure dials 
Pressure reducing valves
One way exploratory valve
Quick for hose connection

Question 30

What are the disadvantage of inhalational sedation?

Answer 30

Expensive 
Need nasal breaking 
Gas expensive 
Space occupying
Difficult to accurately determine dose
Staff addiction 
Chronic exposure

Question 31

What are the signs of adequate sedation?

Answer 31

Pt relaxed
Pt awake
Reduced blinking rate
Laryngeal reflexes not affected
Gag reflux obtunded 
Mouth open on request
Decreased reaction to pain
Decreased spontaneous movement 
Verbal contact maintained

Question 32

What are the symptoms of adequate sedation?

Answer 32

Mental and physical relaxation 
Lessened awareness to pain
Parasthesia of extremities 
Euphoria 
Lethargy 
Floating feeling 
Warmth
Dreaming 
Altered awareness of time

Question 33

What are the signs and symptoms of over sedation?

Answer 33

Mouth closing repeatedly 
Spontaneous mouth breathing
Nausea Vom
Sluggish responses 
Deceased co operation
Incoherent speech
LOC
Pt not enjoying effects

Question 34

What are the pre op instructions?

Answer 34

Have a light meal
Take any routine meds
Children must be accompanied by adults
No alcohol 
Sensible clothing

Question 35

What should the mixture dial be set to befor the treatment starts?

Answer 35

100% oxygen.

Question 36

What should the flow be set to befor the treatment starts?

Answer 36

5-6l/min

Question 37

How much should you reduce O2 by?

Answer 37

10% first and then after 80% reduce by 5%

Question 38

How should you perform the recovery after treatment?

Answer 38

Increase O2 gradually by 10-20% then administer 100% O2 for two mins

Question 39

What is the success rate for RA?

Answer 39

50-90%
Better in ortho xla
Worse in pain

Question 40

T/F adults undergoing RA can leave unaccompanied?

Answer 40

T

Question 41

T/F children can leave unaccompanied after RA?

Answer 41

F

Under 16 need a competant adult

Question 42

What does RA succes depend on?

Answer 42

Appropriate selection and assessment