Nitrous delivery & technique Flashcards
what are the 2 main types of Nitrous delivery?
- Demand Flow Unit
* Continuous Flow Unit
what are the 3 main parts of a demand flow unit?
mixing valve, pressure regulator, demand valve
what are the 2 main components of a continuous flow unit?
flowmeters, reservoir bag
what is the advantage of portable nitrous tank units?
economics
Regulators reduce pressure from ________ psi to a safe _______psi
from 750-2200psi to a safe 45-55psi
what are the 4 types of terminal apparatus?
Nasal Cannula
Nasal Hood
Full Face Mask
Scavenging Nasal Hood
flowmeters display the gas in motion with an accuracy of __%
±2%
T/F: the N2O tube is blue & fluted
FALSE
N2O blue & non-fluted
Flowmeters can adjust output in increments of __ liters
0.1 L
what does the “non-silencable” alarm signal?
Oxygen depletion
all flowmeters come equipped with am Emergency _______ _________ Valve
Air Intake
what are the safety features of N2O systems?
1) Minimum O2 liter flow
2) Minimum Oxygen Percentage
3) DISS - different diameter and different thread
4) PISS- pin index safety system
5) Oxygen Fail-Safe
6) Emergency Air Inlet
7) Alarm
8) O2 Flush Button
9) Reservoir Bag
10) Colo(u)r Coding
11) Quick-Connect Positive Pressure O2
what are the 3 types of Inhalation units?
- Accutron - N2O lock
- Porter - automatic vacuum
- Matrx
why is an automatic interlock system important to use?
Use an automatic interlock system to assure that the N2O cannot be turned on unless the scavenging system is also activated
the scavenging system exhaust rates (flow rates) should be at least ______ liters per minute (L/min)
45 L/min
If concentrations of N2O are above ____ ppm in work areas, increase the air flow into the room or increase the percentage of outside air
25 ppm
Nitrous oxide/oxygen when used in combination with sedative agents may produce what levels of sedation?
anxiolysis, conscious or deep sedation or general anesthesia
T/F: During administration of enteral and/or combination inhalation-enteral conscious sedation (combined conscious sedation), AT LEAST one additional person should be present in addition to the dentist
true
If nitrous oxide and oxygen delivery equipment capable of delivering less than ___% oxygen is used, an in-line oxygen analyzer must be used
25%
during the use of N2O, how is Oxygenation monitored?
- Color of mucosa, skin or blood should be continually evaluated.
- Oxygen saturation must be evaluated continuously by pulse oximetry.
during the use of N2O, how is Ventilation monitored?
- Must observe chest excursions.
* Should auscultate breath sounds or monitor end- tidal CO2.
T/F: Oxygenation must be monitored continuously, even during recovery periods when only oxygen is being used
True
- patient must have continuous supervision until oxygenation, ventilation and circulation are stable
The doctor must determine and document that _______, ______ and ______ are stable prior to discharge
oxygenation, ventilation and circulation
which receptor is needed for the action of Nitrous oxide?
The NMDA Receptor Subunit NMR-1
N-methyl-D- aspartate receptor for its action in C. elegans
how are the fail-safes of N20 systems tested?
A) Plumbed: disconnect oxygen
B) Portable: close tank valve
C) Both: try to give >70% nitrous oxide
how do you “titrate” N2O?
1) start with 10% Nitrous
2) wait 2-3 minutes
3) increase by about 15%
how can you evaluate the level of nitrous sedation?
1) Listen to words, but also how they respond: slowly, monotone, relaxed sound?
2) evidence of sedation:
- Visibly settled into chair
- Hands relaxed
- Legs uncrossed
- Eyes not following all movement in room
what are the signs of over sedation?
A) Closed eyes
B) Slow verbal responses
C) Can’t keep mouth open
D) Hard to engage in conversation
what information must be included in your notes?
Document length of sedation, % used, comment on effectiveness, post-oxygenation time
