October 5, 2017
Outline for identifying and correcting any risks associated with Dental Nitrous Oxide Sedation provision to allow provision of a Risk Assessment
To allow compliance with NIA-2017-001
- Identify in how many surgeries Inhalation Sedation is used within the facility.
- Identify and name the equipment used i.e. type of flowmeter and whether supplied by medical gas piped system or mobile 4-cylinder stand mounted.
- Identify a member staff to be appointed to overall management of this equipment. If a central medical gas piped system is in place, then this should have a regular plan of inspection and care, over and above the annual maintenance visit to the sedation equipment.
- Note service record for this equipment and provider. Regular annual maintenance should be taking place.
- Identify and name the scavenging arrangement. This is normally divided into two sections; breathing system and method of active draw. Both must be identified and named along with the type of nasal hoods/sizes available.
- Monitoring; this is a grey area and whilst good practice, is not currently mandatory. However, it would be an excellent idea in the current circumstances to consider conducting some monitoring using Diffusion Pens during a normal sedation session. Pens should be worn by dentist, dental nurse with a control for background levels in the dental surgery. Current exposure levels in the U.K. are 100 PPM (Parts Per Million) over an 8-Hour TWA (Time Weighted Average). This should be easy to achieve with good Active Dental Scavenging. Be wary of Companies offering expensive on-site monitoring as these do not consider the wider picture and can be a waste of time and money.
- Also note all and any methods of passive scavenging; open doors or windows, low level extraction fan, room air changes (12-15 p/hour). Staff Rotation.
- Note all records of sedation training, where trained and when.
- Note any ongoing vCPD training in inhalation sedation and where conducted.
- Consult your equipment supplier or maintenance company for current help and advice.
Janet Pickles
R A Medical Services Ltd
Ref: RAM/09/17/001
Tel: 01535 652444
Email: janet@ramedical.com