Anyone use Ntrous Oxide in their ED?

sjt9721, BSN, RN · Oct 21, 2008

We used it in the Parkland ED several years ago. Patients were required to hold the mask themselves; you couldn't hold it for them or strap it to their head. I seem to remember mostly using it for I&D's (along with local).

I don't recall any special certification or training. It was all OJT (on-the-job) at the time. :eek:

RedCell · Oct 21, 2008

I am hoping to present to my hospital administration the benefits of Nitrous Oxide in the ED, but would love some feedback from others who have used it. Also, where can a nurse get Nitrous Oxide certified?

What do registered nurses know about diffusion hypoxia or any other various complication that relates to N2O? If you have a situation where you need an inhalational anesthetic gas, call anesthesia. :nurse:

northshore08 · Oct 21, 2008

What do registered nurses know about diffusion hypoxia or any other various complication that relates to N2O? If you have a situation where you need an inhalational anesthetic gas, call anesthesia.

Nitrous oxide is used by EMS in ambulances all over the country. I have not met any anesthetists that ride with the paramedics, have you? :nurse:

northshore08 · Oct 21, 2008

I am hoping to present to my hospital administration the benefits of Nitrous Oxide in the ED, but would love some feedback from others who have used it. Also, where can a nurse get Nitrous Oxide certified?

Does your local EMS use nitrous? You may be able to get policies/procedures from them. I haven't seen it used in any ED I have worked in. I like the idea of using it for I&D; and since it's used in dentists' offices, the idea of ED use might be a possibility.

babynurselsa, RN · Oct 22, 2008

We used to use it in one of the ERs that I worked at years ago. We would use it for things like burn debridement, fx and such. I havve read some articles that it is popular in many peds ERs for such procedures also.

ZippyGBR, BSN, RN · Oct 22, 2008

Nitrous ue is widespread in emergency care in the Uk ...

However we use 'Entonox' ( the BOC tradename for the mixture) which is 50% nitrous and 50% oxygen pre mixed, the main concern ( pre hospital) is that it 'settles' when cold - which can be problematic when you have ambulances or RRVs parked out doors or first responders at events have it outside on very cold days for long periods of time ...

in terms of 'certification' i don't know about leftpondia but it;s officially a Pharmacy med in the UK which means that it can be adminstered by none health professionals and doesn't require a 'full' Patient group directive only a adminstration guideline when used by Health professionals

as sjt9721 said it's 'self adminstered' via a demand valve so an awful lot of the risks associated wth inhalational anaesthesia are eliminated by the virtue of 2 simple risk control methods

1. self adminstered

2a. use premixed 'entonox' - which assuming your gasses are stored indoors shouldn't ever pose a problem with seperation in the ED setting

2b. use an oxygen analyser and alarms you use a system with seperate O2 and nitrous feeds ( if you feed from 'wall' gases the apparatus should have a back up o2 system (e.g. a C or D cylinder)

EDMISSYRN · Oct 22, 2008

Children's Hospital of Minnesota has a well established nurse administered nitrous oxide program. Check out this link and it may change your mind...http://xpedio02.childrensmn.org/stellent/groups/public/@xcp/@web/@whatsnew/documents/policyreferenceprocedure/web097261.asp

EDMISSYRN · Oct 22, 2008

Here is another link to check out :up:

http://xpedio02.childrensmn.org/stellent/groups/public/@xcp/@web/@healthprof/documents/policyreferenceprocedure/web135213.asp

mmutk, BSN, RN, EMT-I · Oct 23, 2008

I don't know of any EMS systems in TN that use nitrous oxide.

N20RN · Apr 3, 2009

Nitrous Oxide Oxygen Sedation is extremly safe, and highly effective for reducing pain and anxiety in pediatrics and adults! There is a plethora of evidence based literature supporting the safe, and efficacious administration of nitrous oxide oxygen sedation by EMS and Registered Nurses worldwide.

The key to success is in part attributed to the pharmakenetics, pharmacodynamics, fail safe delivery equipment and additional continuing education required by nitrous oxide oxygen sedation professionals.

Visit www.NitrousSedation.com a listserve / website for all health care professionals seeking information on Nitrous Oxide Oxygen sedation.

ZippyGBR, BSN, RN · Apr 3, 2009

i would suggest if you are sedating people with nitrous you are using too much ... the main reason is that entonox ( 50 % nitrous 50% O2) works really well and that's self administered via demand valve ....