Aiding in the administration of nitrous oxide-oxygen analgesia



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AIDING IN THE ADMINISTRATION OF
NITROUS OXIDE-OXYGEN ANALGESIA

Denise M. Bowen, R.D.H., M.S.

Associate Professor and Chair

Department of Dental Hygiene

Idaho State University


Adopted by the Idaho State Board of


Vocational Education and the

Idaho State Board of Dentistry


1991

(Edited January, 2005)

TABLE OF CONTENTS

COURSE OUTLINE………………………………………………………………… 4

COURSE SCHEDULE……………………………………………………………… 5

INTRODUCTION…………………………………………………………………... 6

BROAD OBJECTIVES……………………………………………………………… 6

BACKGROUND INFORMATION…………………………………………………. 7

Physiological Effects of Nitrous Oxide……………………………………… 8

Pharmacological Effects and Properties of Nitrous Oxide…………………… 11

Side Effects and Adverse Reactions………………………………………….. 13

ANESTHESIA AND ANALGESIA…………………………………………………. 14

Stages of Anesthesia………………………………………………………….. 15

Planes of Analgesia: Clinical Effects…………………………………………. 15

INDICATIONS AND CONTRAINDICATIONS FOR NITROUS OXIDE-

OXYGEN INHALATION SEDATION……………………………………………… 21


Primary Indications…………………………………………………………… 21

Indications with Special Consideration………………………………………. 22

Contraindications…………………………………………………………….. 23

ARMAMENTARIUM……………………………………………………………….. 25

The Central Storage System………………………………………………….. 25

Nitrous Oxide-Oxygen Machine……………………………………………… 25

Breathing Apparatus………………………………………………………….. 26

Safety Features……………………………………………………………….. 27

PROCEDURES FOR ADMINISTRATION OF NITROUS OXIDE……………….. 28

Vital Signs……………………………………………………………………. 28

Preanesthetic Preparation…………………………………………………….. 30

Techniques for Administration………………………………………………. 31

Legal Chart Entries and Other Legal Considerations………………………… 35

CONTROVERSY IN LITERATURE RELEVANT TO NITROUS OXIDE……….. 38

Occupational Exposure………………………………………………………. 38

SELF EXAMINATION……………………………………………………………… 40

BIBLIOGRAPHY……………………………………………………………………. 43

EXPANDED FUNCTIONS FOR THE DENTAL ASSISTANT

AIDING IN THE ADMINISTRATION OF NITROUS OXIDE




COURSE OUTLINE

Course Description


This course is designed to provide the practicing dental assistant with the background knowledge necessary for aiding in the administration of nitrous oxide-oxygen analgesia.


  1. Physiologic and Pharmacologic Effects of Anesthesia

  2. Side Effects and Adverse Reactions

  3. Analgesia vs. Anesthesia

  4. Indications and Contraindications

  5. Clinical Manifestations of Analgesia/Anesthesia

  6. Armamentarium Used in the Administration of Nitrous Oxide

  7. Preanesthetic Preparation

  8. Techniques for Administration

  9. Legal Considerations and Chart Entries

  10. Occupational Exposure

  11. Current Literature

The course is intended to involve six hours of lecture. A comprehensive final examination is administered to the students who complete this course. A 75% score is required on the written final examination in order to obtain certification for “aiding in the administration of nitrous oxide.” Clinical experience is not required because dental assistants cannot legally administer nitrous oxide-oxygen analgesia.

Required Text

Bowen, D.M. Aiding in the Administration of Nitrous Oxide-Oxygen Analgesia, Adopted by Idaho State Board of Dentistry and Idaho State Board of Vocational Education, 1991.



COURSE SCHEDULE

Week 1: Three Hours

-Physiologic and Pharmacologic Effects


-Side Effects and Adverse Reactions

-Analgesia vs. Anesthesia

-Indications/Contraindications

-Armamentarium



Week 2: Three Hours

-Pre-anesthetic Preparation


-Vital Signs

-Technique for Administration

-Legal Considerations

-Occupational Exposure



F I N A L E X A M I N A T I O N




AIDING IN THE ADMINISTRATION OF


NITROUS OXIDE-OXYGEN ANALGESIA

INTRODUCTION

This module provides instruction in the administration of nitrous oxide-oxygen for analgesic purposes. The term “nitrous oxide” will be utilized throughout the module to indicate this type of administration.


The technique and procedures described represent one method for administration of nitrous oxide. Several other methods are employed by various practitioners; however, this technique has been selected due to two advantages:


  1. It individualizes administration for each patient; and,

  2. It has been utilized safely in a number of clinical situations.

The module has been designed to provide necessary instruction based upon the assumption that no previous knowledge exists relevant to the topic. The reader should complete each portion of the module and answer the self-examination included. In this manner, all pertinent information can be understood clearly.



BROAD OBJECTIVES




  1. Describe the physiologic effects of nitrous oxide inhalation.




  1. Describe the pharmacological effects of nitrous oxide.




  1. Explain the indications and contraindications for the use of nitrous oxide analgesia based upon a thorough medical and personal history evaluation.




  1. Describe the stages of anesthesia and the planes of analgesia including signs and symptoms of each.




  1. Discuss and identify clinical symptoms of a patient at the various levels of nitrous oxide sedation.




  1. Aid in the proper administration of nitrous oxide to a dental patient.




  1. Monitor all signs and symptoms of nitrous oxide sedation in a clinical setting.

8. Be aware of methods for handling possible side effects.


9. Discuss legal considerations involved with administering nitrous oxide in the dental office and record proper legal chart entries.
10. List and explain all parts of nitrous oxide equipment and describe necessary care and maintenance.
11. Discuss occupational hazards associated with chronic exposure of dental personnel to low levels of nitrous oxide.




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