Knowledge Hub
Getting Started with Conscious Sedation
Your complete guide to setting up inhalation sedation — from regulatory requirements to equipment selection and ongoing compliance.
Choose Your Path
Which guide do you need?
We have tailored getting-started guides for dental practices and medical aesthetics clinics. Pick the one that matches your setting.
Dental Guide
Full in-page guide for dental practices — from regulatory requirements to equipment selection and ongoing compliance.
- HTM 01-06 / IACSD guidance & compliance
- Flowmeter, scavenging & monitoring overview
- Setup, training & maintenance checklist
Aesthetics Guide
Reference guide for medical aesthetics clinics — quick orientation on equipment options and clinic setup.
- Common aesthetic procedure suitability
- Digital vs analogue & demand vs continuous flow
- Scavenging & cylinder storage essentials
The starting point
Definition of Conscious Sedation
“A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out.”
Where Do I Start?
Jump to the section that matches where you are in your planning.
What we are seeing
Trending in UK practice
Signals from practices we supply, install, and service — what is driving interest in inhalation sedation right now.
Growing demand from NHS
Increased interest in inhalation sedation — possibly generated by scarcity of available dental GAs and rising patient waiting lists.
High-street, private & corporate
Enhanced demand from practices looking to increase patient choice and grow income.
Paediatric & special needs
Growing use of IHS in community dental for treating paediatric and special-needs patients.
Analogue still popular
Despite IPC concerns, no significant shift towards digital flowmeters — analogue models remain equally popular.
The hardware
Inhalation Sedation Equipment Overview
Two manufacturers, two ranges — both supplied, installed, and supported by R A Medical across the UK and Ireland.
Porter Instruments
Hatfield, Philadelphia, USA
Matrx Analogue MDM (Quantiflex)
CurrentThe UK's most popular sedation flowmeter. First developed in the 1960s and still going strong — robust, reliable, capable of up to 20 years' service with annual OEM maintenance.
- O₂/N₂O glass flowtubes with in-ratio oxygen fail-safe
- Mixture percentage dial + total flow control with auto-compensation
- O₂ flush, air-intake valve, non-rebreathing check valve
- Min 30% O₂ / max 70% N₂O
- Standard ISO with DISS fittings
Dimensions: 21.6 × 12.7 × 27.9 cm (8½ × 5 × 11 in) · 2.9 kg
Matrx Digital MDM (DMDM)
End of Life — supportedDigital MDM with flat touch screen, audible/visual O₂ failure alarms, and an auxiliary O₂ port for a demand-valve resuscitator. No longer sold as new, but still supported by R A Medical for up to 10 years from the date of original purchase.
- Touchscreen + LCD, auto-compensating
- Audible and visual O₂ failure alarms
- Auxiliary O₂ port for resuscitator
- Min 30% O₂ / max 70% N₂O
- Standard ISO with DISS fittings
Dimensions: 11.4 × 20.3 × 26.7 cm (4½ × 8 × 10½ in) · 2.6 kg
Porter C3000 MXR
CurrentThe smallest dedicated sedation flowmeter available. White-bodied with dual-seal fail-safe, emergency air-intake, and 100% O₂ flush. Designed with infection control in mind — the perspex cover lifts to wipe behind, and the stainless-steel flow/mixture knobs are removable and autoclavable.
- Dual-seal fail-safe, emergency air-intake, 100% O₂ flush
- Perspex cover removable for cleaning
- Autoclavable stainless-steel knobs
- Min 30% O₂ / max 70% N₂O
- Mobile 4-cyl stand, bracket, high/low stand mountable
Dimensions: 22.9 × 12.7 × 19 cm (9 × 5 × 7½ in) · 2.6 kg
Porter Midas
LatestPorter's flagship digital flowmeter — a colour touchscreen head with Bluetooth and app compatibility for remote use, N₂O lock PIN for controlled access, gas usage tracker logging the last 50 sessions, on-board diagnostics, and updatable software. Auto-compensation mixer with built-in gas cutoff alarms. Standard ISO with DISS fittings. Available as head only (6050-UK) or as a complete package with mobile 4-cylinder stand (6050-1001/P).
- Colour touchscreen interface with intuitive controls
- Bluetooth + app compatibility for remote use
- N₂O lock PIN for controlled access
- Gas usage tracker — logs last 50 sessions
- On-board diagnostics + updatable software
- Auto-compensation mixer
- Built-in gas cutoff alarms
- Standard ISO with DISS fittings
Dimensions: Head unit: tablet-format touchscreen · mobile stand: 4-cyl, braked casters
Porter mounting range
Mobile 4-cyl Stand (PMP)
93–114 × 53.5 × 53.5 cm · 11.2 kg
Holds 2× E O₂ + 2× E N₂O · in-use + reserve per gas
Swing Arm Bracket
Telescoping arm extends 15"
Pipeline-fed only · requires bottom mounting peg
Low Mobile Stand
Column 16–24" · 5-leg base 20×20"
Pipeline-fed · no yoke assembly · 2–3 m hose
High Mobile Stand
Column 29–37" · 5-leg base 20×20"
Pipeline-fed · no yoke assembly · 2–3 m hose
Midas Telescoping Wall Arm
Dedicated arm for the Midas head · white powder coat
Pipeline-fed · extends to clear patient chair
Accutron Inc
Phoenix, Arizona, USA
Ultra PC™ % Flowmeter
CurrentWhite-bodied analogue model with single-knob total flow control, nitrous oxide ratio control with oxygen fail-safe, O₂ flush at 100% L/min, emergency air valve, directional check valve, and oxygen resuscitator connection.
- O₂ flow range 1–10 L/min · N₂O flow range 0–7 L/min
- 100% O₂ flush, emergency air intake
- O₂ resuscitator connection
- Min 30% O₂ / max 70% N₂O
- Standard ISO with DISS fittings
Dimensions: 11 × 27 × 20 cm · 2 kg
Digital Ultra Flowmeter™
CurrentAccutron's digital unit — dual digital and analogue flow indication for each gas with audible and visual warning alarms. Solid metal case, robust and reliable. Flat touch screen compatible with barrier shields for infection control.
- O₂ flow range 1.0–9.9 L/min · N₂O flow range 0–6.9 L/min
- O₂ fail-safe, directional check valve, O₂ flush
- O₂ resuscitator connection
- Min 30% O₂ / max 70% N₂O
- Flexmount: brackets, bi-fold, telescoping, high/low stands
Dimensions: 11.4 × 20.3 × 26.7 cm (4½ × 8 × 10½ in) · 2.6 kg
Accutron mounting range
Mobile 4-cyl Stand (top)
Min 31⅜" / max 41⅜" with Ultra PC · 36⅜" with Digital Ultra
Same operating principle as the Porter PMP
Mobile 4-cyl Stand (S bracket)
Lower / less obtrusive profile
Ultra PC only — not compatible with Digital Ultra
Telescoping Wall Arm
Extends 12–17" · white powder coat
Ultra PC + Digital Ultra Flexmount
Bi-Fold Wall Arm
Extends to 16" · white powder coat
Ultra PC + Digital Ultra Flexmount
High / Low Mobile Stand
High: 39¼" with Ultra PC
4-leg base · pipeline-fed · no yoke assembly
The interface
Breathing Systems
A range of breathing systems to suit different clinical preferences and infection-control requirements. Mix and match with available disposables.
Most popularPorter Brown Scavenger
The industry standard. The outer hood is clear so the clinician can see fogging on exhalation and confirm the inner liner is correctly seated. The autoclavable inner liner remains grey. Hood assembly (part 5054) includes 3 inner liners.
ReusableGrey Autoclavable
Reusable grey mask and tubing system — economical and environmentally preferred for high-volume practices. All components should be inspected regularly and replaced if showing signs of wear.
DisposableGreen/White Single Patient Use
Single-patient-use breathing system — ideal for IPC in high-throughput environments. Available in a range of scents and colours for patient comfort and stock rotation.
Newer systems
Porter Silhouette
A newer low-profile nasal mask system gaining popularity alongside the traditional Porter Brown. Features autoclavable sizer masks (S/M/L) for accurate patient fitting, clear unobstructed access to the mouth for the operator, and an adhesive strip for secure placement.
Accutron Axess
A modern low-profile nasal mask system from Accutron with the Axess Scavenging Circuit (part 53005) and Axess Extension Tubing (part 53004) for active scavenging. Available in Small, Medium and Large low-profile nasal masks, scented and unscented. Compatible with Accutron flowmeters and most modern scavenging systems.
Accutron Clearview
The Accutron Clearview breathing system — single-use nasal hoods paired with the Clearview Scavenging Circuit II (part 43003) with integrated 0–30 psi pressure gauge. Nasal hoods available in Paediatric, Adult and Large Adult sizes in five scents (Outlaw Orange, Sassy Strawberry, Birthday Bubblegum, French Vanilla, Fresh Mint), plus a capnography sampling variant. Latex-free.
Product change (from 2022): The Porter Brown double mask is now supplied with a clear outer mask (it was previously solid grey). The autoclavable inner liner remains grey. The clear outer allows observation of ‘fogging’ on exhalation and confirms the inner liner is correctly seated.
Rev A1 · 07-2022
Waste-gas removal
Scavenging & Active Draw
Safe removal of waste nitrous oxide is essential for staff safety and regulatory compliance. Must be compliant with COSHH and HTM 02-01. ‘Active’ draw is defined as an air flow rate at the nasal mask of 40–45 L/min (see HTM 02-01 Chapter 10 and Appendix L).
AGSS Terminal + AGS Adapter
Connection to an Anaesthetic Gas Scavenging System (AGSS) terminal using our special AGS Adapter. The most integrated option in hospital and large-practice settings.
HVE Port on Chair Suction
Connection to the chair suction port — must be a High Volume Port. Low-volume ports do not provide sufficient draw and will allow waste gases to leak into the surgery.
Miniscav Stand-alone Pump
A stand-alone cased pump with dedicated external venting — ideal for surgeries without an AGSS or suitable HVE. Quiet, compact, and easy to install.
STAFF PROTECTION
Nitrous Oxide Exposure & Monitoring
Effective scavenging captures the bulk of waste N₂O — but residual leakage around the mask, patient exhalation, and connection points means clinical staff can still be exposed. HSE and Control of Substances Hazardous to Health (COSHH) guidance recommends personal and area monitoring to verify controls are working. R A Medical supplies three complementary monitors, covering personal (breathing-zone) and area (background) measurement.
Medclair EXPO.p
NewestMedclair's personal N₂O exposure monitor — worn in the breathing zone (clipped to a collar or pocket) throughout the working day. Uses infrared gas-absorption sensor technology to deliver real-time visual and audio alarms, with personal logging of ppm levels and timestamps. Exposure data is downloaded to PC via the Medclair Data Reader software for analysis and compliance reporting. This is the current product; it succeeds the earlier Medclair NOD (Nitrous Oxide Detector) — same form factor, same use case, upgraded sensor and logging.
- Real-time N₂O ppm display in the breathing zone
- Visual + audio alarms when exposure threshold exceeded
- Logs ppm with timestamps for later review
- Infrared gas-absorption sensor technology
- Compact, pen-sized, all-day-wear
- Data extracted via Medclair Data Reader (PC)
Dimensions: Pen-style wearable · pocket- or collar-mount
QED G200 N₂O Analyser
CurrentHandheld N₂O analyser from QED Environmental Systems (a Graco company) — designed to safety-check both background and breathing-zone N₂O levels. Measures 0–1000 ppm with Peak, Store, and Hold functions. Rechargeable battery, sample inlet, and an integral stand for hands-free use. A standard tool for occupational hygienists and practices running their own exposure audits.
- Measures 0–1000 ppm N₂O
- Peak / Store / Hold data functions
- Handheld, battery-powered, with integral stand
- Sample inlet for direct air reading
- For background AND breathing-zone surveys
- QED Environmental Systems (Graco company)
Dimensions: Handheld · battery-powered · integral stand for hands-free use
Gradko N₂O Diffusion Tube (DIFMLS51)
CurrentA passive silver-and-brass diffusion sampler from Gradko, used for time-weighted-average (TWA) nitrous-oxide exposure measurement. Worn within the breathing zone across a measured shift (typically 4–8 hours), the tube absorbs N₂O at a known rate; it is then sealed, returned to Gradko's laboratory, and analysed to give a TWA concentration in ppm. The classic low-cost, no-power method for COSHH exposure assessment — ideal as a periodic check on the readings of a real-time monitor, or as the primary survey tool for small practices.
- Time-weighted-average (TWA) N₂O measurement
- Passive — no batteries, no calibration by the user
- Worn in the breathing zone during a measured shift
- Lab-analysed by Gradko, UKAS-accredited report
- Silver tube with brass end-fittings and protective cap
- Ships with chain/cord clip for collar or lapel
Dimensions: Tube: ~7 cm × 1.3 cm dia. · brass end-fittings
Pre-installation
Planning Your Setup
Once a requirement for IHS has been identified, the following must be considered — pre-planning is vital to ensure all requirements are adequately met (including scavenging venting and cylinder storage).
Site preparation
- • Number of surgeries to be used for IHS
- • Multiple rooms may need a piped system (mobile stand-alone still works if all surgeries on the same floor)
- • Allow for scavenging venting and cylinder storage
- • Cabinetry design: 500 mm wide cabinet recommended, 300 mm minimum depending on mounting option
- • Example: a swing-arm bracket mounted, pipeline-fed MDM + Miniscav with an internally sliding door needs a 500 mm minimum aperture
Medical gas supply
Two main supply models — driven by surgery layout, patient throughput, and existing infrastructure:
Piped (MGPS)
Central O₂ & N₂O manifold feeds wall terminals in each surgery via colour-coded, gas-specific hoses. Cleanest install; recommended for multiple surgeries or refits.
Stand-alone (mobile 4-cyl stand)
Four E-size cylinders carried on the mobile stand — 2 × O₂, 2 × N₂O (in-use + reserve per gas). No MGPS required; ideal for single-surgery sites or where piping isn’t feasible.
Note: E-size O₂ cylinders hold only 680 gaseous litres — O₂ changes are relatively frequent.
Equipment choice
- • Dedicated sedation flowmeter — analogue or digital
- • Mounting — depends on gas supply: mobile 4-cyl stand (stand-alone) or bracket (piped)
- • Alternative mountings — low/high stand (no yoke) with longer pipeline hoses
- • Breathing systems + IPC considerations
- • Scavenging — see Active Draw above
Ongoing
Maintenance, Compliance & Training
Keeping your equipment safe, your practice compliant, and your team trained.
N₂O Exposure & Monitoring (COSHH)
A "grey area" — there is no specific instruction to monitor under COSHH (HSE Control of Substances Hazardous to Health Ed. Six 2013). Suggested best practice: annual N₂O monitoring with a dedicated detector, and repeat measurements if high or unusual results are recorded.
IPC: Autoclavable vs Single-Use
During the COVID pandemic there was a major shift to disposable breathing-system components. From 2022 we have seen a shift back towards autoclavable masks and tubing. Either way, always have a range of mask sizes to ensure a good patient fit.
Annual OEM Servicing
Recommended annual OEM service — use a manufacturer-trained and authorised provider with ongoing access to spare parts. On-site servicing also gives your engineers the chance to advise on equipment usage.
Breathing system inspection — staff checklist
Once supplied, breathing systems and masks are the responsibility of staff to inspect and care for. Replace any component showing signs of wear.
Reservoir bag
Check ferrule neck area for holes or perishing — replace if damaged
8 ft grey vacuum hose
Pinch between finger and thumb — if it compresses easily, replace
Inner liner flapper valve
Often missing or cockled — replace
Vacuum control block
Inspect all round for damage or missing components — replace
Bodok seal (cylinder stand)
Vital gas-tight seal between port and cylinder valve — replace if missing
Cylinder restraints
Prevent excessive movement; protects pin-index system
Miniscav units follow a rolling programme: Year 1 on-site service check, Year 2 service exchange.
Training sources
Where to get trained (and stay trained) in inhalation sedation:
NEBDN
Dental Sedation Nursing Syllabus
SAAD
National Course in Sedation for Dentists & Dental Nurses
Dental Hospitals
Follow the NEBDN syllabus
Deaneries
Training and study days
Ongoing CPD
Various modules
Private Trainers
1:1 and group options
Your next step
Your Setup Checklist
Tick off what you already have in place — then send us the selections below for a tailored, no-obligation quote.
2 of 2 key requirements still to check
Dental checklist
Request a Tailored Setup Quote
Tell us which head, mounting, and breathing system you’re considering and we’ll prepare a quote for you. No obligation, no spam — usually a reply within 1 working day.
Prefer to talk it through? Call us on +44 (0) 1535 652444