Statement from Porter Instruments re Inhalation Sedation as a non AGP

Use of nitrous oxide is not an aerosol producing procedure.  Aerosol producing procedures (in relation to “gas flow”) involve positive pressure, intubation, high flow oxygen therapy, use of nebulizers, etc.  Essentially forcing gas flow to the patient regardless if they are inhaling it or not.

The descriptions in the article (copied below) are misleading in the sense that someone would think “any gas flow will cause aerosols”.  This is not the case.  The examples below are assuming there is high flow gas being forced to the patient – AND not scavenging.  So in those scenarios – with no scavenging – gas is blowing on a patient, could pick up moisture from the patient – and “blow into the room air”.  That is the risk.

With dental systems – there should always be scavenging – there is no excess gas blowing on a patient.  The reference to “Continuous Flow” below is also misleading.  There is no “continuous flow” to the patient.  If they are using a traditional breathing circuit – they are matching the breathing volume to the bag.  Gas is flowing into the bag – not to the patient.  If they are using a product such as Silhouette – yes there is gas flowing to the patient (no bag) – however there is scavenging.  Any gas that is not inhaled by the patient is taken out the scavenger.  This is visually demonstrated by the infra-red videos that we did years ago.

The conclusion with use of nitrous oxide and risk of aerosolization – there is no additional risk presented with use of any of our systems compared to a patient sitting in a chair breathing room air.  Actually – there is probably if anything – reduced risk because we are covering the patients nose (limiting what can be exhaled into room air) – and utilizing a scavenging system to pull away patient exhalation.  You could debate that use of nitrous oxide is actually presenting a safety improvement.