– 25 –
If the pressure reducers are showing less than 50 bar o
2
or 30 bar n
2
o (with 10-litre cylinders), it is recommend-
ed to replace the relevant gas cylinder before a sedation.
Apply the pulse oximeter to the patient. Slowly open the
gas cylinders to the left and switch on the nitrous oxide
mixer. 5 l/min. of pure oxygen flow automatically. you
can reduce or increase the breathing bag fill level using
the flow controller on the right. Switch on the suction
unit and place the nasal mask on the patient once the
bag is well inflated.
Keep an eye on the breathing bag. The breathing bag
serves as a reservoir for the mixed gas and helps you
monitor breathing and breathing capacity. It shows
whether the gas flow rate is optimally adjusted in l/
min. the patient automatically takes in the mixed gas
through inhaling. the breathing bag compresses each
time the patient takes a breath. It should not be inflated
too much, as then gas would escape and too much gas
would be consumed. At the same time, the breathing
bag should never deflate fully. If this happens, howev-
er, the valve for room air suction opens, ambient air is
drawn in and the sedation cannot take effect properly.
the folds at the side of the breathing bag should always
be clearly visible. If the breathing bag is too full, reduce
the total flow. If the bag is empty, increase the total flow
immediately.
During sedation, ensure the patient’s
respiration is visible from the bag.
If the bag does not
show breathing movements, this may indicate that the
mask is not positioned correctly and it should be reposi-
tioned. A small bag (e.g. 2.3 litres) is recommended when
treating children. When treating adults, use a 3-litre bag.
you can now use the left concentration controller to
add nitrous oxide to the mix, as learned in the advanced
training course. titrate the nitrous oxide individually for
each patient. to end the nitrous oxide sedation, press
the “recovery” button and switch off the unit after a
suf-
ficient recovery phase
with pure oxygen. the length of
the recovery phase depends on the length of sedation
and maximum nitrous oxide concentration. the default
is 5 minutes.
Please note:
It is not possible to make a general statement on how
much nitrous oxide might be needed to sedate a patient.
the necessary mixing ratio CAnnot be estimated on the
basis of height and weight either. the greater a patient’s
lung volume, the more nitrous oxide is required. Athletes
usually need more nitrous oxide than non-athletes. the
nitrous oxide concentration at which a patient is sedated
may vary from day to day.
oUr tIP: Check how much nitrous oxide the patient
received during his last sedation before any new
sedation. you can use this as a rough guide. But you
should still always start with a low dose.
hygiene measures:
oxygen-nitrous oxide mixer and Bag t
Use clean gloves during cleaning and ensure the envi-
ronment is clean and as free of dust as possible.
Clean the outsides of the mixer and the Bag t with a mild
disinfectant approved for cleaning healthcare equip-
ment (no scouring agents). Do not spray the disinfectant
directly onto the components to be cleaned. Instead,
spray it onto a lint-free cleaning cloth which you can
then use to wipe down the components. the cleaning
agent must be wiped off at the end so that no residue is
left. In case of the variants designed for installation only
clean the display, frame and Bag t as described above.
other hygiene measures:
double nasal mask scavenger system
and breathing bag:
Consult the relevant instruction manual for cleaning the
scavenger system and bag.
7. hANDLINg AND hYgIENE
