Chapter 10: Pain assessment and management
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Complications
Effects such as euphoria, disorientation, sedation, nausea, vomiting, dizziness and generalized tingling are commonly described. These are generally minor and rapidly reversible (BOC Healthcare [19]). If the patient experiences any of these complications, ask them to stop inhaling the gas (BOC Healthcare [19]).
Inappropriate inhalation (if patient already has an altered state of consciousness) of Entonox will ultimately result in unconsciousness, with the patient passing through stages of increasing light‐headedness and intoxication. The treatment is moving to fresh air or using bag valve mask resuscitation (BOC Healthcare [19]). Inappropriate inhalation can be avoided by conducting a thorough assessment of the patient prior to Entonox administration.
Safety in the environment
Inhalation of a gas has the potential to contaminate the working environment (BOC Healthcare [19]). The manufacturer (BOC Healthcare) and the UK Health and Safety Executive recommend that Entonox should only be administered in a well‐ventilated area to limit the average occupational exposure level of the healthcare professional to less than 100 ppm (over an 8‐hour period) (BOC Healthcare [18], Health and Safety Executive [75]).
