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Can you-

 Explain the difference between Entonox and Nitrous Oxide-oxygen mix?

 List the common paediatric procedures that this kind of sedation/analgesia may be used for

and why Nitrous oxide/Entonox is preferred over IV procedural sedation such as Ketamine?

 Explain the contraindications for both Entonox/Nitrous Oxide-oxygen mix?

 Explain the adverse effects of nitrous oxide and their management?

 Demonstrate the set-up of the nitrous oxide-oxygen mixer?

 Demonstrate the set-up of Entonox?

 Explain the role of the nurse pre, during and post nitrous oxide/Entonox administration?

 Explain the documentation that must take place during/post the procedure?

Know & Show Assessment Tool: 

With an approved assess in your E.D.:

Explain the difference between Entonox and Nitrous Oxide

  • Entonox is a premixed Nitrous Oxide/oxygen mix that Health Practitioners cannot adjust the concentration of. Should be able to identify the percentage of Nitrous Oxide contained in Entonox cylinder

List common paediatric procedures that this medication may be used for

  • Insertion of PIVC, Wound cleaning, debridement of burns, Suturing, Lumbar puncture

Explains the benefits of Nitrous Oxide use over IV procedural sedation

  • Conscious sedation less risk of - Short acting sedation - Patient controlled: by depth of breath and holding own mask

List two contraindications for use of Nitrous Oxide;

  • Pneumothorax - Air embolism - Alcohol intoxication - Drowsiness/decreased LOC - Vitamin B12 deficiency - Maxilla-facial injuries

Explains the adverse effects of Nitrous Oxide administration and the management.

Explain the role of the nurse:

-pre sedation- check suction/oxygen/gas levels in cylinders/ resuscitation equipment

-during sedation- monitor ABCD, documentation, effectiveness of sedation/analgesia

-post sedation- monitor ABCD, documentation, delivery 100 % O2 for 3/60 

Explain documentation requirements:

  • effectiveness of drug for analgesia during procedure, any side effects/adverse outcomes (and their management), length of procedure and %’s of gas administered


Demonstrate Demonstrate set up of the nitrous oxide-oxygen mixer
Demonstrate set up of Entonox

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