Nitrous Oxide

OSHA recognizes threshold limit value of :

50 ppm

2. Who is in charge of the safety for employees in the dental office?

Occupational Safety and Health Administration (OSHA)

Which regulatory agency is in charge of •Safety of employee •No Permissible exposure limit (PEL) •Nitrous not carcinogen •Labeling and training •Enforce state rules and regulations for scavenging system

Occupational Safety and Health Administration (OSHA)

Priestly discovered NO2 in

1777

Davy discovered NO2 as a euphoric in

1798

Horace Wells used NO2 for medical purposes in

1844

Morton Esther used NO2 in

1846

Edmund Andrewes started using NO2 for surgery patients in __________. First to titrate it with oxygen

1868

11. What year did the "Father of Anesthesia" become the first person to use nitrous for medical purposes?

1884

Who is the father of anesthesia? A.Horace Wells B. Edmund Andrews C. William Morton D.James Simpson

A. Horace Wells

16. All of the following conditions are considered contraindications of N2O/O2 use EXCEPT one? A.Cerebral palsy B.Sinusitis C.Emphysema D.Recent gastric by-pass

A.Cerebral palsy

17. A digital flowmeter sets the flow of both gases simultaneously. For example, N2O:O2 ratio can be set up at 75%:25%. A.Both statements are true. B.First statement is true and the second statement is false. C.First statement is false and the second statement is true. D.Both statements are false.

A.First statement is true and the second statement is false.

30. Which one of the following agencies regulates the scavenging equipment for nitrous oxide to make the dental office safer for employees? A.Federal Drug Administration (FDA) B.National Institute of Occupational Safety and Health (NIOSH) C.Occupational Safety and Health Administration (OSHA) D. None of the above

A.Occupational Safety and Health Administration (OSHA)

7. When patient describes_____________ he/she reached ideal sedation A.Tingling in extremities B.Numbness around mouth C.Relaxation D.All the above

All of the above

22. Please name the sign(s) of oversedation. A.Detached from reality B.Muscular movement C.Unconsciousness D.Falling asleep E.Irregular breathing F.All of the above

F.All of the above

10. N2O-O2 sedation is contraindicated to the patients who take _______ for cancer treatment. A.Amoxicillin B.Bleomycin C.Clindamycin D.Penicillin

B.Bleomycin

24. Patient who is pale, sweating and has hypotension might be experiencing... A.Allergic reaction B.Syncope C.Drug interaction

B.Syncope

29. Which one of the following is the maximum room air concentration of nitrous oxide? A.400 ppm B.1 ppm C.50 ppm D. None of the above

C.50 ppm

3. All of the following are contraindications for use of N2O in, EXCEPT one. Which one? A.Severe emotional disturbances B. First trimester of pregnancy C.Stressed-induced asthma D. Inability to cooperate or communicate

C.Stressed-induced asthma

4. Patient complaining of headache, nausea and lethargy at the end of the sedation might be experiencing__________ __________. A.Silent regurgitation B.Aspiration C.Diffusion hypoxia D.Respiratory paralysis

Diffusion hypoxia

5. Documentation of a patient appointment should include: A.BP and Pulse B.Start and stop times of N2O C.Procedures performed D.Patient's reaction to N2O E.All the above

E. All of the above

13. What conditions can alter the amount of sedation agent getting to the patient? A.Choanal atresia B.Hyperplasia of adenoid tissue C.Enlargement of tonsillar tissue due to infection D.Broken nose E.All of the above

E.All of the above

•Monitor compliances manufacturing quality

FDA

15. T/F It is more likely to find an aspirated object in the left lung.

False

20. T/F Alcohol hand rubs are just as effective as washing your hands with soap and water.

False

21. T/F Snoring is one of the signs of relaxation and ideal sedation.

False

23. T/F Severe speech impairment is NOT considered a contraindication of nitrous oxide-oxygen sedation.

False

27. T/F Your boss started administration of N2O-O2 sedation at 20%. The patient doesn't feel any effect and in 5 min you can increase it to 30%.

False

6. T/F: When a patient starts giggling, he/she has reached ideal sedation.

False.

•Business Inspection by fire department •Fire extinguisher •Limiting the number of compressed gas cylinders •Size of storage area •Floor level in building

Fire and Safety Inspection

9. Who discovered the euphoric properties of N2O?

Sir Hymphrey Davy

12. T/F Patient who is suffering from allergic rhinitis is not a good candidate for nitrous oxide conscious sedation.

True

14.T/F Health care provider should access patient's breathing rate during dental procedure to prevent hypoxia and hyperventilation.

True

18. T/F One of the differences between digital and Analog flow tube flowmeters is the auto shut-off of nitrous oxide during oxygen flush?

True

19. T/F The conducting tubes and nasal hood are autoclavable.

True

25. T/F Nausea and vomiting are major complications and can be signs of oversedation.

True

26. T/F In a case of silent regurgitation, the N2O should be terminated and O2 increased to 100%.

True

28. T/F A major source of trace nitrous oxide that contaminates the ambient air in a dental office is the patient talking.

True

8. T/F Laryngospasm is a life threating complication that is associated with oversedation with N2O.

True

•Regulates packaging and transportation

US department of transportation

Which regulatory agency is in charge of •Resource •Recommended exposure limit (REL): 25 ppm •Order monitors and read research

•National Institute of Occupational Safety and Health (NIOSH)

Contraindications to NO2

•Recent ophthalmic surgery •Chronic Obstructive Pulmonary Disease (COPD) •Upper respiratory infection •Cystic fibrosis •Pneumothorax •Multiple sclerosis •Conditions of obstructive air spaces (sinuses, middle ear, bowel obstruction) •Severe vitamin B12 deficiency (gastric bypass) •Compulsive personalities •Epilepsy •Emotional instability(Schizophrenia, Alcoholism) •Unable to cooperate or communicate •Mentally handicapped (Alzheimer's, autism) •Patients taking Bleomycin for cancer treatment •Severe personality disorder •Pregnancy-1st trimester (consult in 2nd & 3rd) •Does not want