Mod D Tech 19 Entonox; indications contra-indications and administration

Question 1

Definitions

Entonox

Answer 1

•Analgesic gas for moderate to severe pain / Labour Pain.

Question 2

Definitions

Analgesic

Answer 2

•Analgesic A pain relieving drug

Question 3

Definitions Analgesia

Answer 3

•Analgesia A deadening or lack of pain without

a loss of consciousness.

Question 4

•Indications: Entonox

Answer 4

•Indications: Entonox is for moderate

to severe pain / Labour pains

Question 5

Entonox Cylinders

Answer 5

•Colour: Blue with white quarters

on the cylinder neck.

• Capacity: 660 litres
• Composition: 50% Nitrous Oxide, 50% Oxygen
• •Hazard Labels: Compressed Gas. Oxidising Agent (breaks-down).

Question 6

Care of Equipment entonox

Answer 6

•Storage: Well-ventilated area.

Away from combustible

materials.

•Do not lubricate cylinders and valve

assemblies with oil or

grease-explosion risk.

•

• Store cylinders horizontally.
• Avoid exposure to temperatures less than -5oC, the gases will separate. If this occurs invert the cylinder several times to mix the gases.

Question 7

Advantages of Entonox

Answer 7

•Rapid therapeutic effects (3-5 minutes). May take

5-10 minutes before maximum effect achieved.

• Therapeutic effects wear off quickly – symptoms are not masked during examination at hospital.
• Minimal side effects.
• Does not depress respiratory or cardiac function.
• Self-administered (by patient).
• No dosage requirement.
• Facilitates patient handling and transportation
• Provides a high concentration of oxygen.

Question 8

Contra-Indications

Answer 8

•Bends – (decompression sickness or Caissons disease)* - anyone diving within the last 24

hours should be considered a risk.

• Severe head injuries [with impaired consciousness] (may mask signs and symptoms of the injury)
• Violently disturbed psychiatric patients (difficult to administer).

Question 9

Entonox Cautions

Answer 9

• Penetrating Torso Injury
• Polytrauma involving Chest or Abdomen
• •Pneumothorax
• Pneumomediastinum
• Pneumoperitoneum

Question 10

Entonox Considerations

Answer 10

• Oxygen >50% is required
• Alcohol or drug intoxication – where self-administration may not be understood (potential interaction between gas and drug/alcohol).
• •Young children and those unable to understand self-administration.

Question 11

Entonox administration

Answer 11

• Explain the purpose - pain relief.
• Explain the likely effects:

–Drowsiness and/or dizziness.

–Feeling of intoxication.

–Effects wear off quickly.

–Unlikely to ‘knock-you-out’.

•

•Ensure the patient’s respiratory function is sufficient to operate the demand valve.

Question 12

Entonox administration

Answer 12

• Instruct the patient in the use of the equipment:
• –The mouthpiece is the 1st choice of administration currently; however, if using a mask ensure an airtight seal between the face and the mask

Take normal to deep breaths

•–Record the administration of Entonox on the patient report form and report it to the receiving hospital

Question 13

Entonox Children

Answer 13

Entonox can be given to children provided they can understand the instruction involved.

Question 14

How effective is it?

Answer 14

• Evaluate the pain before administration (OPQRST)
• •Document the patients pain score
• Administer the analgesic
• •Re-evaluate the pain score following administration
• •Remember; Entonox is effective for moderate to severe pain