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Re: Office AnaesthesiaFrom: Andrew Folley (agfolley@hotmail.com)Thu Jan 31 10:57:50 2008
Thanks everyone. Sounds like Nitrous may not be the best way to go. I will check on Entonox steve. I may have to see about having one of the hospital CRNAs come in and do something extra IV such as versed or Propothol?? Date: Thu, 31 Jan 2008 02:29:52 -0600From: Stephen.Raymond@dhhs.tas.gov.auTo: ob-gyn-l@mail.obgyn.netSubject: RE: Office Anaesthesia It may be a British thing, but Entonox would be a very reasonable idea for short office procedures such as Novasure. Is it available in the States? Steve From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Kim E. GoldmanSent: Thursday, 31 January 2008 3:08 PMTo: Multiple recipients of list OB-GYN-LSubject: Re: Office Anesthesia As a board certified oral and maxillofacial surgeon I need to chime in here and say, though it is not complicated you do need proper training to use nitrous, there are some contraindications, and no one should ever deliver nitrous with a system that doesn't have a fail safe valve preventing "blue gassing" someone (giving 100% nitrous). In addition you should have appropriate monitoring equipment (pulse oximetry) and equipment for resuscitation including the ability to deliver 100% 2 via face mask. Also you need a closed system with evacuation of the wasted nitrous, med gas line approval by the state in most states and there are OSHA and other regulations regarding what the facility must have to administer nitrous. There are also state licensure laws for the delivery of nitrous (varies from state to state) and for conscious sedation and for general anesthesia as well as a national board for dental anesthesia. Kim On Jan 30, 2008, at 9:14 PM, R. Daniel Braun wrote: Check with your insurance carrier and do an anesthesia residency. Look out for aspiration, make sure your oxygen tank doesn't run out in the middle of the procedure, and know how to do a Nitrous washout before you start doing this. When I was a resident, we gave nitrous to our attendings patients for deliveries. We had an aspiration pneumonia, we had one lady turn blue because the O2 tank ran out and there was no valve in the room to open another tank. (I took the mask off and let her breathe room air. Luckily she was able to get by that way and didn't have problems from all the nitrous still in her system.I always wondered how those dentists got away with it.Dan On Jan 30, 2008 5:54 PM, Andrew Folley <agfolley@hotmail.com> wrote: Has anyone ever used Nitrous Oxide for office anesthesia??? Dentists use it or use to use it frequently. I have had no luck in eliminating the severe intense pain of the office Novasure which occurs during the 1-2 minutes of ablation. I thought the Nitrous Oxide might be a good solution??? -- R. Daniel Braun, MD FACOG(L) CMTProfessor EmeritusDept. of Obstetrics and GynecologyIndiana U. School of MedicineR. Daniel Braun "Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 CONFIDENTIALITY NOTICE AND DISCLAIMER The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose. _________________________________________________________________ Climb to the top of the charts!=A0Play the word scramble challenge with sta= _________________________________________________________________ r power. http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan
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