Entonox usage in children

Safe use of nitrous oxide in children on the wards

 

 

Indications for use of Nitrous oxide

What are the situations where a Child's discomfort can be reduced with the use of nitrous oxide?

  • IV insertion (with topical anaesthesia)
  • Burns dressings
  • surgical dressing change
  • urinary catheter insertion
  • all of the above

What are the advantages of using nitrous oxide?

  • causes minimal cardiorespiratory compromise
  • can be administered painlessly through inhalation
  • Has some analgesics and sedative properties
  • its quick onset of action and recovery makes it ideal for use on the wards
  • Relatively easy to administer with minimal monitoring
  • all of the above
  • none of the above

What are the disadvantages of using nitrous oxide?

  • Not suitable for 'very' painful procedures
  • can cause dizziness, nausea,hallucinations and occasionally nightmares
  • needs special equipment to administer
  • can rarely cause desaturation or aspiration
  • none of the above

Safety considerations of nitrous oxide

Who is at increased risk of airway compromise during administration of nitrous oxide?

  • Age less than 1 year
  • Acute respiratory infection
  • history of difficult airway
  • all of the above
  • none of the above

Who is at risk of expansion of closed air-filled spaces with nitrous oxide?

  • chest injury, suspicion of pneumothorax
  • abdominal distension or bowel obstruction
  • head injury
  • decompression sickness or air embolism
  • middle ear disease
  • all of the above
  • none of the above

What patient co-morbities are at particular risk from nitrous oxide?

  • pulmonary hypertension or complex cardiac condition
  • metabolic disorders especially related to homocysteine
  • nutritionally compromised patients
  • critical illness
  • all of the above
  • none of the above

Safe administration of nitrous oxide

What equipment is required for administering nitrous oxide?

  • separate oxygen source with mask other than the nitrous oxide oxygen source
  • bacterial filter
  • suction
  • crash cart available
  • gas scavenging unit
  • none of the above
  • all of the above

What observations need to be performed on administering nitrous oxide?

  • oxygen saturations
  • respiratory rate
  • heart rate
  • conscious state
  • all of the above
  • none of the above

Untitled multiple choice question

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