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Frequently Asked Questions
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Equipment for Nitrous oxide/oxygen Inhalation Sedation
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Dedicated purpose-designed machines for the administration of inhalation sedation (formerly termed relative
analgesia) for dentistry should be used. Such machines should conform to British Standards and be
maintained according to manufacturers' guidance with regular, documented servicing.
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Scavenging of Waste Gases must be active and sufficient to fully conform to current C.O.S.H.H. standards.
Breathing systems should have a separate inspiratory and expiratory limb to allow proper scavenging. Nasal
masks should be close fitting providing a good seal without air entrainment valves.
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Conscious Sedation in the Provision of Dental Care
Report of an Expert Group on Sedation for Dentistry DOH 2003
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| Q. |
What equipment is required for administration of Inhalation Sedation?
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The basic requirement is a purpose-designed Flowmeter, medical gas supply - either an installed pipeline or
mobile four cylinder stand with a scavenging system for nitrous oxide.
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| Q. |
Why do I need to use an Active Scavenger Breathing System?
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| A. |
C.O.S.H.H. and H & S require that staff are protected from exposure to waste nitrous oxide in the surgery
environment. Chronic exposure to nitrous oxide has been linked to occurrences such as spontaneous
abortion and reduced fertility.
The currently recommended occupational limit of exposure is 100 ppm (parts per million) over an 8-hour
TWA (Time Weighted Average). This can only be achieved by use of the following: Active Scavenging
(defined as a flow rate of 45 lpm at the nasal hood), Staff rotation and good surgery ventilation or room air
changes (recommended 12-15 per hour).
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A number of active scavenger breathing assemblies are available from different manufacturers.
A study published in 2002 stated:
"This study compared the effectiveness of three nitrous oxide scavenging systems,
the Porter/brown, the Accutron, and the Matrx, in actual time during use in a standardized
mock dental treatment protocol that reflected clinical practice while minimizing the influence
of confounding variables. At every occasion during the procedure, the Porter/brown scavenger
system left the operatory with significantly less nitrous oxide than any of the other scavengers
tested. The Porter/brown removed between 71% and 91% of the nitrous oxide compared to
the control (no device)."
Clinical evaluation of the efficacy of three nitrous oxide scavenging units during dental treatment
Certismo, Walton, Hartzell, Farris General Dentistry Sept-Oct 2002
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