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  • 1.  Use of nitrous oxide in clinic

    Posted 11-01-2023 12:59

    One of our Urology practices is interested in implementing patient initiated nitrous for clinic procedures.  Its a service we currently don't provide in any of our Surgical Services clinics. Interested in others' experience, clinical competencies, staff education, etc.

    Thanks!



    ------------------------------
    Deb Battle, MS, RN, CEN, TCRN, NP-C
    Director, Patient Care Practice - Surgical Services
    Emory Healthcare/The Emory Clinic
    Atlanta, GA
    404-556-0969
    ------------------------------


  • 2.  RE: Use of nitrous oxide in clinic

    Posted 11-07-2023 14:43

    Hi Deb,

    One of our urology clinics just started patient administered nitrous. I believe the vendor is Nitronox. We are still working out the processes. We are currently working with risk management to develop a guideline, IT to create an order for nitrous and also working with the anesthesia department to make sure that we are following all of the rules and regulations. It's been challenging because although it is patient administered, the nursing staff still needs to setup the equipment as well as titrate with directions from the provider. Currently, only our RN's and LPN's are allowed to titrate. As far as education, we had the vendor come to train the staff and utilized their checklist. Another thing to consider is BLS vs ACLS. We are still determining which is needed. Also nursing documentation. We are currently using a dot phrase to capture the documentation for the nursing staff. 



    ------------------------------
    Tomika Green MSN RN AMB-BC
    Nurse Clinician
    VCU Medical Center
    Henrico VA
    (804)647-0199
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  • 3.  RE: Use of nitrous oxide in clinic

    Posted 02-23-2024 20:48

    Nitrous oxide is not anesthesia and should not require ACLS. When you stop nitrous oxide it is out of the patient's system in about a minute, it can be quicker if you place the patient on 100% oxygen. The most common side effect is nausea. I hope that is helpful



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    Sheilah Kean, MSN, RN, CENP
    Interim Primary Care Director
    Dena'ina Wellness Center
    Soldotna, AK
    907-355-7556
    ------------------------------

    Original Message


  • 4.  RE: Use of nitrous oxide in clinic

    Posted 02-24-2024 08:21

    Appreciate the feedback. Thank you.

     

    Deb Battle, MS, RN, CEN, TCRN, NP-C

    Director, Patient Care Practice – Surgical Services

    404-778-1013 (Office)

    404-556-0969 (Cell)

    1365 Clifton Road

    Building A, 4th Floor – A4257

    Atlanta, Georgia 30322

     

    image001.png@01D671A5.7528D0C0

     




    Original Message


  • 5.  RE: Use of nitrous oxide in clinic

    Posted 02-25-2024 07:35

    Nitrous oxide has dissociative properties and patients may experience mild hallucinations while under the effects of the drug.  
    Most common side effects are headache and nausea. 
    The ADF is an Australian Foundation that has expressed concern over the black-market availability and use of nitrous oxide. 
    Perhaps the attached references will help. 

    The Drug Wheel.
    Drug Facts - Alcohol and Drug Foundation
    2018 Administration of Nitrous Oxide
    Prescribing reference for Nitrous Oxide. FDA. 

    ---------------

     

    Aleesa M Mobley PhD APN  (she/her/hers) Why Pronouns Matter

    Assistant Professor - Clerkship Director [Pain Management/Substance Use Disorder]

    Physical Medicine & Rehabilitation - Neuro Musculoskeletal Institute 

    Lippincott Procedures: Subject Matter Expert - Wolters Kluwer Publishing


    Rowan Medicine Bldg., 42 E. Laurel Rd, Ste 1700, Stratford New Jersey 08084 

    T: 856-566-7010 | F: 856-566-6956| C: 856-230-1229 

    mobley@rowan.edu | som.rowan.edu 


    Learning is not attained by chance, it must be sought for with ardor and attended to with diligence [Abigail Adams (1744 - 1818), 1780].



    Original Message


  • 6.  RE: Use of nitrous oxide in clinic

    Posted 02-23-2024 20:46

    I am sorry that I am just now seeing this. I completed my doctoral dissertation on the use of nitrous oxide in labor and delivery. I also want to use nitrous oxide in our Family Medicine practice for IUD insertions and other painful procedures (placed on the back burner for other pressing projects). Nitronox will connect you with your local vendor. There are options for fixed rate versus adjustable rate, even with the adjustable rate there is a safety stop. Once you get set up with your Ntironox vendor they should provide you with sample check-offs that other organizations have used. The most difficult part in my experience is determining if your company wants to attempt billing the service (I don't recommend, very few insurances cover it) and then getting the documentation set up. It is important to have dosimeters for your staff present during the use of nitrous oxide. There are studies showing a link between dental assistants exposed to nitrous oxide and decreased fertility. If you other questions I am happy to discuss my experience with you. 



    ------------------------------
    Sheilah Kean, MSN, RN, CENP
    Interim Primary Care Director
    Dena'ina Wellness Center
    Soldotna, AK
    907-355-7556
    ------------------------------



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