Nitrous Oxide Flashcards
Indications for Use of N20/02 Sedation
(3)
- Anxiety
- Gagging
- Painful Dental Procedures
Contraindications for Use of N20/02 Sedation
(7)
- Upper Respiratory Infections
- Inability to Communicate
- Head or Facial Injuries
- Pregnancy (First trimester)
- Claustrophobic Patients
- Severe behavioral problems in children (Uncooperative)
- Middle ear Infections
- Upper Respiratory Infections
- May be unable to breathe through nose
- Inability to Communicate
(2)
- Important to be able to assess level of sedation
- Inability to understand the procedure
Pre-op instructions for the parent
(4)
- Give your child little or no food 2 hours prior to the appointment.
Occasionally nausea or vomiting may occur to a child with a full
stomach - Let your student doctor know of any respiratory conditions that may
make breathing through the nose difficult for your child. - Let your student doctor know if any medications were taken on the
day of the appointment. - Have the patient use the restroom before they are seated in the
dental chair
Pre-op instructions for the child
(7)
- Practice tell, show, do throughout the procedure
- Show the child the reservoir bag that they will blow up like a
balloon by breathing through his or her nose. - Relax and practice breathing in and out through your nose
- Keep your mouth closed
- Your hands and feet might feel tingly
- You may feel warm
- You may feel sleepy
- Practice tell, show, do throughout the procedure
(2)
– Show the child the mask prior to placement
– Tell the child he/she will be wearing a mask like an astronaut
Reserving N2O/O2 Unit
(3)
Reserve a N2O/O2 Unit at the dispensary as
soon as possible prior to the day of the
appointment
* Check oxygen and nitrous levels before you
leave the dispensary area
* Do not forget the Nitrous Hood and Hoses
before leaving the dispensary area
— Cylinder is Oxygen
— Cylinder is Nitrous
Green
Blue
A full tank/cylinder is —
Tank below — must be replaced prior to use
2000
1000
Nitrous oxide is stored as a
liquid and not as a gas. Nitrous
level will always read at 700
Tank below 700 must be replaced prior to use.
To use:
Turn – “loose” to open valves
Turn – “tight” to close valves
left
right
Use a — for infection
control.
headrest cover
— is turned on to a very low level
(you will hear a slight whistle)
Suction
— is turned on to a very low level
(you will hear a slight whistle)
Suction
Turning the suction hose upside down or
leaving it on the floor prevents
the hoses
from kinking
Reservoir Bag
Bag should initially
be
Push the flush button to fill
reservoir bag
empty and flat
2/3 full
Administration Guidelines
* Equipment must be completely assembled — to
seating your patient – it’s okay to unwrap
everything and get it ready
* Once nitrous is in use, a student doctor, faculty or
trained staff must be
* A parent or legal guardian must be present at the
appointment (at chairside or in the waiting area)
* You are not allowed to administer more than —%
N2O to a pediatric patient
* Monitor patient for signs of
prior
with the patient at all times
40
over sedation (sleep,
snoring or lack of response to stimuli) and adjust
concentration as necessary
Signs of Over-sedation
(4)
- Drowsiness
- Sluggish or delayed response
- Inability to move or communicate
- Fixed eyes
Set O2 at 100% at a flow rate of — liters for
the child patient
5
Adjust center knob to —% O2 which will
automatically adjusts nitrous to 10%
90
Titrate every few minutes…..
- — the percent of O2
- to — the percent of nitrous
decrease
increase
Monitor patient continuously….
* If you need to leave your patient,
ask another student,
faculty or trained personnel to monitor your patient until
you return
- Observe your patient’s level of sedation by the patient’s
response to - Monitor respirations by
- Monitor patient’s chest rise for
verbal stimuli
watching the reservoir bag
breathing
Administer 100% oxygen for a minimum of
— minutes prior to discharge
five (5)
At the End of the Appointment
(5)
- Make sure your patient is able to respond to you,
stand and walk without assistance prior to
discharge - Discharge your patient to parent/guardian
- Give Post-op Instructions to parent/guardian
- Check oxygen and nitrous levels
- Disassemble equipment and return to dispensary
- Disassemble equipment and return to dispensary
(2)
- Return hoses in a head rest cover
- Return nasal hood in its original container
Nitrous Experience/Competency Exams – ORAL
SURGERY REQUIREMENT
You may complete the nitrous experience in our department. This is
however an oral surgery requirement not a pediatric dentistry
requirement
* You must tell us that you are going to complete your nitrous
experience before you set up the equipment so that faculty can
observe your set up.
* You may complete your nitrous competency with us as well as long
as you can provide documentation of the previous experiences
required by oral surgery before attempting competency.
* Same rules apply to competency as they do for the experience.
* All questions regarding this experience/competency should be
addressed to oral surgery faculty
