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ENTONOX ANALGESIA
SPECIAL INSTRUCTIONS Must be administered by staff who have had training in use of Entonox Read instructions and safety concerns at reverse Name................................................................................. Surname................................................. Sex. M / F

DOB........................Hosp. ID.................................................. Ward .....................................Room No............................

DRUG NAME

ENTONOX
50:50 NITROUS OXIDE & OXYGEN ROUTE: INHALATION Self administration only
START DATE SIGNATURE DOCTORS NAME PURPOSE OF USE

Pre Entonox Assessment

Checklist Item
Check ID band against prescription Check for any contraindications (see reverse of page) Check for any patient allergies? Oxygen and suction available at bedside? Well-ventilated room? Patient has been NBM (at least one hour) Pulse oximeter required? (if cardiac / respiratory condition) Any analgesic administered prior to procedure?
st

Y/N

Comments

Sign

Anyone in the room in 1 trimester of pregnancy? New face mask and filter used Entonox cylinder pressure adequate? Document pressure Consent obtained for ENTONOX administration?

Entonox use documentation

Date Start Time End Time Hrs Used Minutes used Sign

Post Entonox Assessment

Checklist Item
Any side effects? Good Analgesia? Need for any intervention? E.g. Airway Blood test required? In event of repeated Entonox use Documentation complete? PMR, Audit book , Gas level Clean Handset and Tubing ? Need to replace cylinder? Copy of sheet placed in Audit folder?

Y/N

Comments

Sign

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Contraindications to use of Entonox

Head injuries with impaired consciousness Large / artificial / traumatic / spontaneous pneumothorax Intestinal obstruction Severe bullous emphysema Maxillofacial injuries involving trapped air Following air encephalography

Middle ear occlusion / pathology Decompression sickness Following recent underwater dives

Vitamin B12 deficiency

Special precautions for use of Entonox

1. Repeated or prolonged exposure to nitrous oxide depletes the body's stores of vitamin B12 and very rarely this can precipitate neurological complications.

Patients at higher risk include: Who use Entonox frequently With a poor intake or on a diet low in animal products eg. Vegans With malabsorption syndromes, particularly those with ileal resections On synthetic diets (eg. Phenylketonuria, maple syrup urine disease) On a diet for which special vitamin and mineral supplements are prescribed

2. Only nursing / paramedical personnel trained in the use of Entonox may assist the patient in its use. Note that Entonox is self administered and the patient must be in control of the mask at all times. DO NOT HOLD THE MASK TO THE PATIENT FACE, EXCEPT WHEN TRAINING THE PATIENT ON ITS USE. 3. Ensure the area is well ventilated during and after administration 4. Staff in the first trimester of pregnancy may wish to avoid the area while Entonox is in use