Is it acceptable to use a Nitrous Oxide self-delivery system like Pro-Nox in a business occupancy for pain relief?
Nitrous Oxide Self Delivery Systems
A nitrous oxide self-delivery system, such as Pro-Nox, is designed to deliver a mix of nitrous oxide and O2 and is approved by FDA for pain relief. The agent is not a form of moderate sedation. Nitrous Oxide is non-flammable, but does support combustion the same as oxygen. It is no more or less of a fire risk than a tank of oxygen. While the Pro-Nox system has safeguards to prevent over delivery, there are some safeguards you should consider and document to ensure you are providing safe care and appropriate care in a business occupancy.
Consider the Following Safeguards
Collect the key subject matter experts and document your procedure for the use of this system. Consider the following safeguards:
- Ensure your staff is trained and have documented competencies done by someone competent to review them.
- Ensure that the equipment is on your medical equipment inventory and is subjected to required preventative maintenance. In addition, ensure there is a process for communicating any FDA warnings or recalls about the equipment to the staff using the equipment.
- Work with facilities to ensure there is a scavenge system that is sufficiently capturing leaked nitrous and exhaled nitrous oxide.
- Ensure there are protocols in place for appropriate patient selection. Factors might include age, cognitive ability, procedure being done, etc.
- Ensure there are protocols for appropriate patient draping. In addition, prep to prevent puddling of the gas around the patient face.
- Review any MIFU for compliance.
If it is FDA approved for pain relief, has safeguards and is used appropriately, it is acceptable to use this in a business occupancy.
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