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Dental Nurse Sedation Post Qual Exam > Inhalation Sedation > Flashcards

Inhalation Sedation Flashcards

(64 cards)

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1
Q

What are the aims of inhalation sedation?

A

Anxiolysis (reduces fear/anxiety) & analgesia (reduce pain)
Also to improve cooperation

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2
Q

What does Anxiolysis mean?

A

Reduce fear/anxiety

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3
Q

What does analgesia mean?

A

Reduces pain

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4
Q

How much heavier than air is nitrous oxide?

A

1.5

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5
Q

What coloured cylinders is nitrous oxide supplied in?

A

Blue

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6
Q

What size do nitrous oxide cylinders come in?

A

Size E

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7
Q

What pressure is nitrous oxide stored a liquid under?

A

44bar or750PSI

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8
Q

What are the properties of Nitrous Oxide?

A

Colourless and virtually odourless

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9
Q

How heavy is a full cylinder of Nitrous Oxide?

A

20lbs

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9
Q

How much Nitrous Oxide is needed to produce unconsciousness?

A

70%

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9
Q

What coloured cylinders is Oxygen supplied in?

A

Black with a white shoulder / by 2025 they will all covert to white bodies and carry the name oxygen on them

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10
Q

What pressure is oxygen stored a liquid under?

A

137bar or 2000 psi

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10
Q

What does MAC stand for?

A

minimum alveolar concentration

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11
Q

When referring to gases what does MAC relate to?

A

Potency (strength)

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12
Q

What is the time weighted average (TWA) for staff working with nitrous oxide?

A

100ppm over an 8 hour time period.

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13
Q

What does a half full nitrous oxide cylinder contain?

A

Gas above a liquid

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14
Q

What does a full oxygen cylinder contain?

A

Gas

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15
Q

Who has the legal responsibility for checking the inhalation sedation machine?

A

The treating clinician

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16
Q

Gases used for sedation have a relatively high MAC. What is it?

A

105

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17
Q

The MAC being “high” means that nitrous oxide is?

A

A weak anesthetic

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18
Q

Why is it virtually impossible to produce anaesthesia using nitrous oxide alone in a patient who is adequately oxygenated?

A

The MAC is over 80

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19
Q

At what concentration of nitrous oxide is plane 1 obtained?

A

5-25%

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20
Q

What is the seal called on the oxygen cylinder?

A

Bodok seal

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21
Q

At what concentration of nitrous oxide is plane 2 obtained?

A

20-55%

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22
At what concentration of nitrous oxide is plane 3 obtained?
Above 50%
23
What is plane 1 of analgesia?
Moderate sedation and analgesia Relaxation Tingling in fingers, toes n cheeks Warmth Alert and responsive Pulse/Bp will be normal
24
What is plane 2 of analgesia?
Dissociation sedation and analgesia Relaxation/ sleepiness Possible dreaming Delayed response to questioning
25
What is plane 3 of analgesia?
Total analgesia Marked sleepiness and glazed appearance Nausea and dizziness Vomiting Unresponsive to questioning
26
What is sickle cell disease?
Blood disease, abnormal form of hemoglobin
27
What does inhalation sedation improve?
Gagging
28
In what trimester can inhalation sedation not be used?
1st trimester
29
What is the rapid onset of inhalation sedation?
2-3 minutes - peak: 3-5
30
What is the rapid recovery of inhalation sedation?
3-5 minutes
31
Are electromechanical monitoring mandatory for inhalation sedation?
No
32
Contraindications of inhalation sedation?
Nasal obstruction Claustrophobic patients ASA 3+ Muscle wasting disease (myasthenia Gravis /multiple sclerosis)
33
Indications of inhalation sedation?
Anxiety Needle phobia Pain control Allergic to IV agents Gagging Pt at risks of respiratory depression - asthma/Sickle cell anaemia
34
Why do Sickle cell anaemia and asthma patients benefit from IHS other than IV sedation?
Benefit from a guaranteed oxygen level of at least 30%
35
What is sickle cell anaemia?
Lack of oxygen in the haemoglobin
36
Why would an asthma patient be more likely to have ihs instead of IV?
To avoid respiratory depressive effect. And they will benefit from increased level of oxygen
37
Why would somebody who is diabetic benefit from IHS more than GA?
GA has longer period of starvation
38
Why would somebody with kidney/ liver disease be treated with RA rather than IV or GA?
Drug is not metabolised in the liver
39
Why would somebody with cerebral palsy benefit from IHS?
Reduces involuntary movements
40
What does PSI stand for?
Pound per square inch
41
What is the quantiflex MDM head?
The inhalation machine
42
What on the RA machine is used to titrate the nitrous oxide?
the mixture dial
43
What is the tube on the left of the RA machine showing?
N20
43
What controls the flow rate?
Flow control valve
43
What is the tube on the right of the RA machine showing?
O2
44
How can you inflate the bag without setting the flow rate?
o2 flush button
45
How can you check the reservoir bag has no holes?
Cover the non-rebreathing check valve with hand and inflate bag with o2 flush button. Inspect the bag
46
How often should the bodok seal be changed?
2 years
47
What are the safety checks on the RA machine?
Oxygen fail safe oxygen flush Reservoir bag Minimum oxygen 30% Check inlet valve isn't blocked
48
what is the Air entrainment valve ?
Would operate if the patient was in spontaneous respiration and there was an obstruction in the fresh gas to the patient
49
What is the scavenging system?
Vacuum suction
50
How should Size C, D and E cylinders be stored?
Horizontally on shelves
51
How should Size F, G and J cylinders be stored?
Vertically on concrete floor pens
52
Does Nitrous oxide bind to components of the blood like oxygen?
No it is carried in the blood
53
Whys is there a rapid recovery from nitrous oxide?
It has a poor solubility
54
What is diffusion hypoxia?
Due to the sudden reversal of concentration gradients in the lungs following the discontinuation of nitrous oxide, leading to a decrease in oxygen levels in the bloodstream
55
How can we avoid diffusion hypoxia?
Give 2 minutes of oxygen after tx is finished
56
How long does it take for the patient to feel the initial effect of nitrous oxide?
after 20 seconds
57
How long does it take for the patient to feel the full effect of nitrous oxide?
3-5 mins
58
Where does the nitrous oxide is inhaled, where does it travel to?
Alveoli sacs within the lungs
59
When Nitrous oxide is introduced to the body, how does it get into the blood?
It diffuses through the alveolar membrane into the blood

Dental Nurse Sedation Post Qual Exam (11 decks)

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