Entonox Therapy


	The following information is taken from the JRCALC Pre Hospital Clinical Guidelines. Presentation Entonox is a combination of Nitrous Oxide 50% / Oxygen 50%. It is stored in medical cylinders which have a blue body with white shoulders. Actions Inhaled analgesic agent Indications Moderate to severe pain Dosage and administration Adults: Nitrous Oxide 50% / Oxygen 50% should be self administered via a facemask or mouthpiece by the patient, after suitable instruction. It will take on average, 3-5 minutes to take effect, but it may be 5-10 minutes before maximum effect is achieved. Children: Entonox is safe to use with children provided they are capable of following the administration instructions. Ambulance staff should be informed when Nitrous Oxide 50% / Oxygen 50% has been used. Side effects Minimal side effects. Contra-indications Severe chest injuries where a pneumothorax may be present, as it may expand this. Severe head injuries with impaired consciousness, as it will further impair consciousness. The bends (decompression sickness) where the Nitrous Oxide/Oxygen 50% will expand the size of nitrogen bubbles within the blood stream, further aggravating the problem. Violently disturbed psychiatric patients. Use with caution in patients who have taken alcohol or illicit drugs as Nitrous Oxide 50% / Oxygen 50% may increase the effect of both. Additional Information Nitrous Oxide/Oxygen 50% has major advantages: Analgesic effect is rapid, with minimal side effects. No cardiac or respiratory depression. It can be self administered. Its analgesic effect rapidly reverses, so as not to mask symptoms. Its 50% oxygen concentration is valuable in many medical and trauma conditions. It has an equivalent effect of 10mg of morphine. The usual precautions must be followed with regard to caring for the Nitrous Oxide 50% / Oxygen 50% equipment and the cylinder must be inverted several times to mix the gas when temperatures are low. The mixtures will separate at temperatures below -7 ° Centigrade.