Nitrous Oxide (Entonox) Flashcards
1
Q
General
A
- Consists of a mixture of 50% Nitrous Oxide & Oxygen
- Used as an analgesic for acute, short-term pain relief in diverse range of clinical situations
- There are a # of situations where administering Entonox can have adverse & life threatening side effects
- Take caution to THOROUGHLY rule out contraindications & cautions
- Entonox will increase effects of other CNS depressants
- Air trapped in the body is at risk of expansion
2
Q
Classification
A
Analgesic
3
Q
Action
A
Inhalation of 50% mixture of Nitrous Oxide & Oxygen produces CNS depression as well as rapid pain relief
4
Q
Indications
A
Relief of moderate pain
5
Q
Contraindications - Functional Inquiry
A
- Pneumothorax
- History of Trauma - Air Embolism
- History of IV Therapy
- History of IV Drug use - Inhalation Injury
- History suggests possible inhalation injury - Nitroglycerin
- Nitroglycerin w/in 5 mins - Decompression Illness
- Has PT been diving recently? - Inability to Comply
- Is your PT able to understand & safely self-administer - Enclosed Space
- Assess space for adequate ventilation
6
Q
Contraindications - Physical Assessment
A
- Pneumothorax
- Assess for Chest Trauma
- S&S of Tension Pneumothorax (decreased lung sounds, chest pain, shock) - Air Embolism
- Assess for Deep Vein Thrombosis (swelling in your one foot, ankle, or leg, usually on one side)
- Assess for Pulmonary Embolism (Acute onset Chest Pain, Shortness of Breath, Decreased SPO2)
- S&S of Stroke (FASTVAN) - Inhalation Injury
- Assess for inhalation Injury (Soot, charring, stridor, laryngeal swelling, etc.) - Decompression Illness
- Assess for Decompression Sickness (Pain in joints, lethargy, mediastinal emphysema, subcutaneous emphysema, rash/mottled skin) - Inability to Comply
- AVPU/GCS Scale - Enclosed Space
Open air vent/window etc.
7
Q
Cautions - Functional Inquiry
A
- Depressant Drugs
- Any depressant drugs on board? (ETOH, Cannabis, Morphine, etc.) - COPD
- History of COPD?
- Will Entonox exacerbate?
8
Q
Cautions - Physical Assessment
A
- Shock
- Assess for Shock (LOC, skin colour, review vitals) - Abdominal Distension
- Palpate the abdomen for distension or signs of trapped air - Facial Injuries
- Assess for injuries restricting PT from self administration
9
Q
Side Effects
A
- Drowsiness
- Sedation
- Disorientation
- Headache
- Dizziness
- Vomiting
10
Q
Dosage
A
Self administered
11
Q
Route
A
Inhalation via bite stick
12
Q
Onset, Duration
A
- Onset - Rapid (is this an actual measure of time or colloquial?)
- Peak - Immediate
- Duration - Until discontinued
13
Q
Special Considerations
A
- Entonox must be mixed by inverting the tank 3 times prior to administration
- Always use a bacterial/viral filter between PT & demand regulator
14
Q
Components of an Entonox apparatus
A
- Entonox cylinder
- Medical post
- Pressure gauge
- Demand regulator
- Expiratory valve assembly
- Inspiratory port
- Disposable mouthpiece
- Bacterial/viral filter
15
Q
Explain procedure to patient
A
- Effects of Entonox
- Possible side effects of Entonox
- That Entonox is self administered
- Describe how to use mouth piece (its similar to a dive regulator)
- Ensure area is well ventilated. If you are in an ambulance turn on necessary fans & have partner close their window
- Prepare Entonox by inverting tank 3 times to mix gases
- Open valve on medical post
- Instruct PT to self-administer Entonox
