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Effective Nitrous Oxide/Oxygen Administration for Children

Course Number: 92

Step 2b - Rapid Titration Technique

The rapid titration technique is useful for patients that are extremely anxious or are claustrophobic about having their nose covered with the nasal hood. As nitrous oxide is 1.53 times denser than air it will drop when released into the atmosphere. If the patient expresses claustrophobia with placement of the nasal hood directly on the nose, administration is initiated with a 50% oxygen/50% nitrous oxide concentration prior to seating of the nasal hood (Figure 6). The nasal hood is positioned approximately three inches above the patient’s nose. The nitrous oxide, being denser than air, will drop onto the patient’s nose, the patient will inhale the gas, and hopefully, relax. As the patient relaxes, the nasal hood is brought closer to the nose until it is comfortably positioned on the patient’s nose. The 50%/50% concentration is maintained for 2-3 minutes and then adjusted to 60% oxygen/40% nitrous oxide. The patient is asked to describe what they feel. As above, the concentrations and gas flow volume are adjusted until the patient feels comfortable and the reservoir bag is properly inflated.

ce92 - Content - Step 2b - Rapid Titration Technique - Figure 1

Figure 6. Oxygen: Nitrous oxide concentration for Rapid titration technique