How to Setup and Use Nitrous Oxide. How to turn on and use the nitrous oxide in your emergency department.
This is an excellent choice to provide sedation and anxiolysis. I use this in laceration repair, I/D's and IV starts in peds. It can also be used for pelvic exams, reductions and dental procedures.
Contraindications: 1st/2nd trimester, closed airspace disease like pneumothorax, bowel obstruction, COPD (blebs), otitis media and diving injuries. Furthermore it can increase pulmonary vascular resistance (PVR) and is contraindicated in pulmonary edema, hypertension and mitral stenosis.
The contraindications are due to two issues. Increase diffusion across membranes causing increase in the size of air in various body cavities (like pnuemothorax) and due to an increase in PVR.
If exposed long term it can cause B12 deficiency.
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