Nitrous Oxide

Question 1

Indications for Use of N20/02 Sedation
(3)

Answer 1

• Anxiety
• Gagging
• Painful Dental Procedures

Question 2

Contraindications for Use of N20/02 Sedation
(7)

Answer 2

• Upper Respiratory Infections
• Inability to Communicate
• Head or Facial Injuries
• Pregnancy (First trimester)
• Claustrophobic Patients
• Severe behavioral problems in children (Uncooperative)
• Middle ear Infections

Question 3

• Upper Respiratory Infections

Answer 3

• May be unable to breathe through nose

Question 4

• Inability to Communicate
  (2)

Answer 4

• Important to be able to assess level of sedation
• Inability to understand the procedure

Question 5

Pre-op instructions for the parent
(4)

Answer 5

• 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

Question 6

Pre-op instructions for the child
(7)

Answer 6

• 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

Question 7

• Practice tell, show, do throughout the procedure
  (2)

Answer 7

– Show the child the mask prior to placement
– Tell the child he/she will be wearing a mask like an astronaut

Question 8

Reserving N2O/O2 Unit
(3)

Answer 8

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

Question 9

— Cylinder is Oxygen
— Cylinder is Nitrous

Answer 9

Green
Blue

Question 10

A full tank/cylinder is —
Tank below — must be replaced prior to use

Answer 10

2000
1000

Question 11

Nitrous oxide is stored as a

Answer 11

liquid and not as a gas. Nitrous
level will always read at 700
Tank below 700 must be replaced prior to use.

Question 12

To use:
Turn – “loose” to open valves
Turn – “tight” to close valves

Answer 12

left
right

Question 13

Use a — for infection
control.

Answer 13

headrest cover

Question 14

— is turned on to a very low level
(you will hear a slight whistle)

Answer 14

Suction

Question 15

— is turned on to a very low level
(you will hear a slight whistle)

Answer 15

Suction

Question 16

Turning the suction hose upside down or
leaving it on the floor prevents

Answer 16

the hoses
from kinking

Question 17

Reservoir Bag
Bag should initially
be
Push the flush button to fill
reservoir bag

Answer 17

empty and flat
2/3 full

Question 18

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

Answer 18

prior
with the patient at all times
40
over sedation (sleep,
snoring or lack of response to stimuli) and adjust
concentration as necessary

Question 19

Signs of Over-sedation
(4)

Answer 19

• Drowsiness
• Sluggish or delayed response
• Inability to move or communicate
• Fixed eyes

Question 20

Set O2 at 100% at a flow rate of — liters for
the child patient

Answer 20

5

Question 21

Adjust center knob to —% O2 which will
automatically adjusts nitrous to 10%

Answer 21

90

Question 22

Titrate every few minutes…..
- — the percent of O2
- to — the percent of nitrous

Answer 22

decrease
increase

Question 23

Monitor patient continuously….
* If you need to leave your patient,

Answer 23

ask another student,
faculty or trained personnel to monitor your patient until
you return

Question 24

• Observe your patient’s level of sedation by the patient’s
  response to
• Monitor respirations by
• Monitor patient’s chest rise for

Answer 24

verbal stimuli
watching the reservoir bag
breathing

Question 25

Administer 100% oxygen for a minimum of
— minutes prior to discharge

Answer 25

five (5)

Question 26

At the End of the Appointment
(5)

Answer 26

• 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

Question 27

• Disassemble equipment and return to dispensary
  (2)

Answer 27

• Return hoses in a head rest cover
• Return nasal hood in its original container

Question 28

Nitrous Experience/Competency Exams – ORAL
SURGERY REQUIREMENT

Answer 28

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