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Use of Entonox usually incurs a lower fee because it does not require the presence of a nurse. For that reason it is really so easy to integrate. I’ve never really worked for any dentist that has given it out like there’s no tomorrow but I’ve certainly never met a dentist particularly fearful of its use.
Exactly my point.
Quote:
Also, the person that posted on the nature of Entonox being “self-administered” wasn’t being sinister. The nature of administration means that the patient controls the relative depth of analgesia by the rate at which they breathe... quick breaths giving deeper analgesia and explaining this to the patient probably gives them a greater sense of control... probably one of the best benefits of its use really...?
As you have alluded it was 'common sense' I was advocating not pin the buggers down n enforce sedation. Doh! It is all about calming a phobic patient NOT about imposing yet another reason to restrict podiatric practice. I understand the requirement to impose regulation but surely if something has been proven as safe (given certain restrictions) then to utilise that for the benefit of the patient is in their best interest.
I am 100% for safe practice.
Also 100% for practicing within safe boundaries in the patients interest. If that permits inhalation sedation in the appropriate circumstances I personally do not see a problem.
Regards,
Mandy.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
I practice in Perth WA and we had a short day course in the use of Methoxyflurane approxiamtely 18 months ago. I have since used it a few times on patients who are needle phobic.... mainly children and big burly men!!
It has been very successful and easy to use. We buy it in a single use disposable pack which includes a vial of the drug and the inhaler. The whole thing cost approx $30, which is passed on as an extra fee, to the patient.
Hi Steve, I am interested in the training and use of Methoxyflurane in Podiatry practice. Can you please pass on details of the company which trains? I work in SA. thanks.
Hi Guys,
I spoke last week at podiatry conference to Dr Bothewick, chair of the Medicines committee for the society and apparently Entonox is a pharmacy 'P' item so can be used by podiatrist provided they have the correct training. There is a BOC online course, not sure if that is acceptable (but it is free) or the St John Ambulance run a 1/2 day medical gases course for the public / first aiders.
This thread has been quiet for some time, but just in case anyone is interested! lol.
Previously as both a nurse and paramedic I used Entonox. When I started my podiatry training I was amazed that hardly anyone used it, or had heard of it outside 'childbirth' lol.
As a result I set about doing some research and for my podiatry degree dissertation looked at the questions 'Could Entonox inhaled analgesia be of use in podiatric practice'.
To cut a long story short here are some findings:
Yes HPC Pods can use entonox (subject to local policy etc if NHS)
Yes it reduces pain, but does not eliminate it.
Therapeutic effect is similar to 10mg Morphine
Anxyiolytic effects are equal to and safer than diazepam etc
If used correctly and self administered, you cannot overdose.
Can be used with children (Provided they can suck the gas from the demand valve)
Effect wear off within 5-10 mins
Generally if they walk into your clinic, they probably dont have the contra indications to its administration.
Side effects - common, nausea and dizzyness - but wear off within minutes
You can drive 30 mins after use (Unlike L/A)
Some of the more common use would seem to be for:
Needle phobics
Anxyiolitic properties
Any quick painful procedure without L/A (Especially if they are driving)
Joint manipulations etc
Those are just some points, if your really interested in finding out more including how it works in terms of pharmocological properties etc drop me a message.
Colin
The Following User Says Thank You to cjhopper1 For This Useful Post:
I too agree that analgesic gas has a very valuable place in podiatry. The problem I find is the cost of its use in comparison with ongoing costs. IE. Most patients (in my private practice) do not require its use, although there are some who would benefit. Keeping a supply aboard (so to speak) would not be viable in my small podiatry clinic. BOC quoted a ridiculous amount for its supply. Sadly this prevents me from offering a valuable option to patients.
Kind regards, Mandy.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
If seems like from left base, please forgive - but you should all be aware of it. Now we live in a world of fast transport, people are often seen "out of context". For instance, scuba divers are reporting to hosptitals far distant to the sea, with decompression sickness. One of their symptoms is joint pain - for which they are being given entonox for relief. This is a disaster for decompression sickness (AKA Bends) as it is caused by an excess of blood nitrogen in the first place. It is because of the "out of context" that it happens - had it been a coastal hospital, the attending physician would be aware of the possibility and ask the right questions. So what I am saying guys (as a retired diving instructor), is for goodness sake check that the person you are about to entonox has not been diving within 48 hours. Rob
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
If seems like from left base, please forgive - but you should all be aware of it. Now we live in a world of fast transport, people are often seen "out of context". For instance, scuba divers are reporting to hosptitals far distant to the sea, with decompression sickness. One of their symptoms is joint pain - for which they are being given entonox for relief. This is a disaster for decompression sickness (AKA Bends) as it is caused by an excess of blood nitrogen in the first place. It is because of the "out of context" that it happens - had it been a coastal hospital, the attending physician would be aware of the possibility and ask the right questions. So what I am saying guys (as a retired diving instructor), is for goodness sake check that the person you are about to entonox has not been diving within 48 hours. Rob
Hi Rob,
I quite agree with what your saying as an ex Royal Navy Medic. That said anyone using Entonox should only be doing so if they have been trained to do so, and this would include contra indications,including any person who has been diving within 48hrs, suspected pneumothorax, or raised intra cranial pressure, including people who have recently had eye or bowel surgery where gases may have been used to inflate a cavity as part of the procedure.
I too agree that analgesic gas has a very valuable place in podiatry. The problem I find is the cost of its use in comparison with ongoing costs. IE. Most patients (in my private practice) do not require its use, although there are some who would benefit. Keeping a supply aboard (so to speak) would not be viable in my small podiatry clinic. BOC quoted a ridiculous amount for its supply. Sadly this prevents me from offering a valuable option to patients.
Kind regards, Mandy.
Hi Mandy,
Another company you can try is SP Services, they provide ambulance/first aid equipment and supply entonox kits and cylinders.
Another option is to see if there is a St John Ambulance unit near you, they will have spare cylinders, it may be for a donation they will loan you one, then when it needs replacing you pay them the cost of replacement, that is what i have done previously. Or chat to the station manager of the local NHS Ambulance service.
Worse case scenario is they say no lol.
Regards
Colin
The Following User Says Thank You to cjhopper1 For This Useful Post:
Another company you can try is SP Services, they provide ambulance/first aid equipment and supply entonox kits and cylinders.
Another option is to see if there is a St John Ambulance unit near you, they will have spare cylinders, it may be for a donation they will loan you one, then when it needs replacing you pay them the cost of replacement, that is what i have done previously. Or chat to the station manager of the local NHS Ambulance service.
Worse case scenario is they say no lol.
Regards
Colin
Many thanks for that Colin.
Regards,
Mandy.
__________________
:)
twirly
Mandy Brooks
Brooks Podiatry
S64 0DE
Suffering a fondness for odd things.
“ Though the mills of God grind slowly;
Yet they grind exceeding small;
Though with patience he stands waiting,
With exactness grinds he all. ”
Hi, I am happy to try and answer questions about the use of entonox in podiatry, as this was the subject of my dissertation for my podiatry degree. I have also used entonox as both a nurse and paramedic in the past, and I am a medical gases trainer.
Regards
Colin
The Following User Says Thank You to cjhopper1 For This Useful Post:
One of the problems of getting old, whether as a Pod or a diving instructer (I am both), is that you become a grumpy old man. I made comment about entonox earlier in this debate. From a pathology point of view there is worse to come; SCUBA diving in my day was done with compressed air - too easy we might say...... an up-and-coming shift is towards altered gas mixtures, commonly known as "Nitrox" which, for the purpose of this address, may be thought of as a nitrogen depleted, oxygen enriched breathing mixture. The divers rationale is to increase bottom times without a need for decompression. It does disgusting things to blood gas tensions, nitrogen absorbtion, oxygen toxicity etc etc. Now that might be fine in a well organised industry such as The Royal Navy. which has the surface support that it needs - recompression chambers, destroyers, medics etc. It is not fine, IMHO for divers like me in a Zodiac. And it does have implications for the dispensers of entonox - much in line with my above comment - for goodness sake make sure they have not been diving with 48 hours - we no longer know what our clients have been breathing.......... and I do not mean illicit substances! Rob
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
One of the problems of getting old, whether as a Pod or a diving instructer (I am both), is that you become a grumpy old man. I made comment about entonox earlier in this debate. From a pathology point of view there is worse to come; SCUBA diving in my day was done with compressed air - too easy we might say...... an up-and-coming shift is towards altered gas mixtures, commonly known as "Nitrox" which, for the purpose of this address, may be thought of as a nitrogen depleted, oxygen enriched breathing mixture. The divers rationale is to increase bottom times without a need for decompression. It does disgusting things to blood gas tensions, nitrogen absorbtion, oxygen toxicity etc etc. Now that might be fine in a well organised industry such as The Royal Navy. which has the surface support that it needs - recompression chambers, destroyers, medics etc. It is not fine, IMHO for divers like me in a Zodiac. And it does have implications for the dispensers of entonox - much in line with my above comment - for goodness sake make sure they have not been diving with 48 hours - we no longer know what our clients have been breathing.......... and I do not mean illicit substances! Rob
Hi Rob,
I agree with you (again lol), but my response to your previous comment remains the same. Entonox should only be used by practitioners who have been trained and are competent to do so, this includes knowing the contra-indications to it's use (including diving). So there should not be a problem.
Regards
Colin
The Following User Says Thank You to cjhopper1 For This Useful Post:
Re: Entonox (nitrous oxide)
Re: Entonox (nitrous oxide)
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