Increasing Your Child's Comfort with Nitrous Oxide

January 23, 2013 Deborah Worthington, RN, CPN

You may be familiar with “laughing gas” as something you find at the dentist’s office but did you know it can also be used when your child is a patient at Swedish? Laughing gas is a mix of nitrous oxide and oxygen, but you might hear your pediatric nurses just call it “nitrous.” In pediatrics, we use it to help a patient relax and feel more comfortable during certain procedures such as IV placement or urinary catheterization.

Once your doctor or nurse has determined that your child is a good candidate for nitrous (without any contraindications such as conditions where air may be trapped in the body, pregnancy, or impaired level of consciousness), your nurses and certified child life specialist (CCLS) will explain the process: Your child will choose a flavor for the inside of their mask used to administer the gas. They will be on a stretcher or bed and have a saturation probe attached to a finger to monitor their oxygenation. One nurse will administer oxygen, then the nitrous, gradually increasing the amount until your child is suitably relaxed for the procedure, while remaining responsive to directions. Another clinician will perform the procedure, e.g., place the IV. A doctor is also available.

As a parent you are welcome to be at your child’s side to provide additional comfort. The room is kept quiet with minimal noise; depending on your child’s age and habits, you may like to talk or sing softly to him or her. The gas takes effect rapidly, making procedures easier for both patient and clinician. The gas is maintained at the specific level needed to keep your child relaxed throughout the procedure. When the procedure is completed, (in this example, an IV is placed), the nitrous is stopped and the oxygen continued for an additional 2-5 minutes. Nitrous wears off quickly and allows your child to rapidly return to his or her original level of consciousness.

An additional benefit of nitrous is a patient being able to eat beforehand and not having to fast (as with surgery). If eating before nitrous, we recommend a patient have a light snack as a way to minimize the potential for nausea and vomiting. These, along with sweating, are the most common side effects.

Nitrous can be used for both inpatients and short-stay patients whether in the pediatric treatment room, at the bedside or in the pediatric emergency department. Nitrous is just one way pediatric nurses work to increase your child’s comfort during a stay or visit at Swedish.

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