Abstract

Aims: To describe the experience of using high concentration nitrous oxide (N₂O) relative analgesia administered by nursing staff in children undergoing minor procedures in the emergency department (ED) and to demonstrate its safety.

Method: Data were collected over a 12 month period for all procedures in the ED performed under nurse administered N₂O sedation. All children greater than 12 months of age requiring a minor procedure who had no contraindication to the use of N₂O were considered for sedation by this method. The primary outcome measure was the incidence of a major complication namely respiratory distress or hypoxia during the procedure. Secondary outcome measures were minor complications and the maximum concentration of N₂O used.

Results: Data were collected for a total of 224 episodes of nurse administered N₂O sedation over a 12 month period. In 73.2% of children no complications were recorded. One major complication was recorded (respiratory distress) and the most common minor complication was mask intolerance in 17%. The mean maximum concentration of N₂O used was 60.2%.

Conclusions: N₂O is a safe analgesic in children over the age of 1 year undergoing painful or stressful procedures in the ED. It may safely be administered in concentrations of up to 70% by nursing staff after appropriate training.