Guide
3 Pages
Preview
Page 1
-1-
INFORMATION FOR NITROUS OXIDE SEDATION GETTING STARTED Before you do, check that both the Oxygen (02) and Nitrous Oxide (N20) cylinders are connected to the Accutron flowmeter unit via the regulators mounted on the cylinders. 02 and N20 GAS CYLINDERS Check contents. Turn ON one cylinder at the time. Oxygen – should read – Green is FULL and when on Red it is EMPTY. Nitrous Oxide – Only drops when 70% Empty (this is because Nitrous Oxide is in liquid form). When it reaches the white line Indicating 70% empty, you will have approx. 2 hrs usage left. Important note: All Accutron flowmeters machine have an inbuilt fail-safe system set at minimum of 30% Oxygen delivery meaning that never at any one time will you be able to deliver above 70% of Nitrous Oxide gas ensuring that your patient will never be unconscious. SCAVENGING TUBING CIRCUIT. Connect the scavenging hose from the machine to the vacuum hose by way of the adaptor (supplied).
PATIENT NASAL HOOD. Select the appropriate hood for your patient refer to Hood sizes and scents). Make sure the inhalation circuit is complete. Now turn on the 100% Oxygen supply to 8 l/min whilst you fit the hood over the patient’s nose. This is so the patient will feel comfortable breathing through the nasal hood, prior to introduction of Nitrous Oxide.
-2-
THE ACCUTRON DIGITAL ULTRA FLOWMETER The right side TOTAL FLOW -/+ controls TOTAL FLOW of both 02 and N20 gases. By increasing the TOTAL FLOW , the machine will commence gas flow as indicated by the LPM display. Note if Nitrous Oxide flow is set to 0%, only oxygen will be administrated to the patient. The left side % N2O -/+ controls how much Nitrous Oxide gas you are administering, This being in % concentration and as indicated on the Main Blue LED display as adjusted with the -/+ controls The right side TOTAL FLOW control then allows you to vary the total flow rate of both O2 and N20 in proportion to the % N20 as set of the left side lever.
For example, the respiratory rate of the Patient will be higher at commencement of administration. As they are becoming sedated their respiratory rate will decrease. This can be compensated by reducing the right side TOTAL FLOW control as indicated by the Reservoir Bag (see below) You can see the differing rates of 02 and N20 being administered on the smaller LED readouts on the middle bottom of the unit. These will vary based on the TOTAL FLOW Adjustment and the % N20 being delivered. Note. Once you have attained the correct dosage for that patient, record the numbers on their record card for future use. RESERVOIR BAG. The Breathing Bag (or Reservoir bag) on the Sedation unit is for monitoring the patient’s respiratory volume compared to the total flow coming for the Flowmeter. In other words, it is indicating if the machine is set to provide enough gas flow to suit the patient’s breathing. If the bag is empty, the gas flow rate from the flowmeter is set too low for the patient. If the bag is full the flow rate may be set to high, allowing you to reduce the total flow setting at the unit to compensate. Ideally you want the bag to be approximately 1/2 to 2/3 full and constant. Remember that the respiratory rate of the patient will vary over the administration, especially at the onset of the Nitrous Oxide gas flow as the sedative effect starts. ROOM AIR OVERRIDE. This is a special valve which opens and allows the patient to breathe room air should gas flow from the machine be too low (indicated by the empty Reservoir Bag) to avoid diffusion hypoxia. This is a safety feature. THE O2 FLUSH is an important Safety Feature that allows you to provide 100% Oxygen to the Patient at high concentration for as long as the operator holds the O2 flush button. This provides immediate reversion of the Nitrous Oxide Sedation Effect through administration of Oxygen only. This overrides any other setting on the Flowmeter unit for as long as the O2 flush button is pressed, which in case of an emergency should be held until the patient is returned to full consciousness.
-3-
PATIENT ADMINISTRATION. This is a guide only and does not constitute proper instruction or training. As mentioned above total flow is achieved by adjusting the right side TOTAL FLOW -/+ controls to either increase or decrease total flow rate. . The Flowmeter accurately show the gas flows you are administering to your patient. For a starting point of total flow rate for an individual patient, use patient weight / 10 For example, if your patient is approx.80Kg divide by 10 which equals 8 which translates to 8 l/min. This should be your starting Oxygen Flow rate (induction). So what is a ‘good’ dosage to obtain a satisfactory result? With ALL patients START with 20% Nitrous Oxide gas flow using left side % N20 Control for at least one minute, then titrate the N20 in 10% increments per minute to 30% - 40% which seems to be the average patient dose. Note some patients may require a higher N20% dose but care should be taken not to provide too high dosage. The aim of Conscious Sedation Nitrous Oxide is to provide a relaxed and comfortable patient that is acceptable to allow the dental treatment. They should be responsive at all times. At end of the procedure, reduce N20 to 0% and leave flow at 100% O2 for a minimum of three minutes to flush the residual Nitrous Oxide from the Patient and to avoid Diffusion Anoxia. A few points to note. -
Smokers usually require higher Nitrous Oxide sedation levels as their lungs are less efficient at absorbing Nitrous Oxide.
-
Nasal passages need to be kept clear. Do not administer Nitrous Oxide Sedation should your patient have a cold and/or have a nose blockage.
The Five Advantage of Nitrous Oxide Sedation in Dentistry. 1. Nitrous oxide sedation is a very safe, economical and efficient treatment method. Nitrous oxide sedation is an extension of the services on offer at your practice. 2. Nitrous Oxide sedation fills the gap between local and general anaesthesia. 3. Nitrous oxide sedation is ideally suited for the treatment of patients with anxiety, children and patients with a low pain threshold. 4. The intensity of sedation can be very well controlled at all times through the percentage mixture of nitrous oxide. The dentist can determine the depth of sedation on an individual basis, as required. 5. Nitrous Oxide Sedation remains the only Analgesic that can be quickly reversed to bring the Patient to full Consciousness.(through the administration of 100% Oxygen).