Entonox

Question 1

PPE

Answer 1

Don PPE as required.

Question 2

Indications

Answer 2

Moderate to severe pain
Labour pains

Question 3

Contraindications

Answer 3

Chest injury and clinically
suspected pneumothorax
Severe head injuries with impaired
consciousness
Decompression sickness (consider
this with anyone who has been
diving in the past 24 hours)
Violently disturbed psychiatric
patients.
Intraocular injection of gas within
the last 8 weeks.
Abdominal pain where intestinal obstruction is suspected

Question 4

Cautions

Answer 4

Any patient at risk of having a
pneumothorax,
pneumomediastinum and/or a
pneumoperitoneum (e.g.
polytrauma, penetrating torso injury)

Question 5

Equipment check

Answer 5

Locate Entonox bottle and ensure
the contents gauge show sufficient
contents for administration.

In low temperatures, invert the
bottle several times to mix the
gases.

Question 6

Prepare patient

Answer 6

Ensure patient is capable of
following the administration
instructions and activating the
demand valve.
Provide the patient with a
thorough explanation:
- This takes around 3-5
minutes to take effect,
with maximum
effectiveness reached
within 10 minutes.
- There are minimal side
effects however, they
may feel dizzy or
delirious.
- The analgesic effect will
rapidly wear off following
discontinuation of use.

Question 7

Instruct Patient

Answer 7

Instruct patient to inhale and
exhale via the demand valve.
Slow deep breaths provide a more
effective administration of the
analgesia.

Question 8

Reassess

Answer 8

Assess for effectiveness of the analgesia.

Question 9

Paediatric considerations

Answer 9

Nitrous oxide is effective in
children provided they are capable
of following the administration
instructions and can activate the
demand valve.

Question 10

Report

Answer 10

Accurately document/hand over
any relevant information regarding
the clinical skill