Equipment
Inhalation sedation equipment guide
Janet Pickles from RA Medical Services Ltd offers important advice for clinicians thinking about purchasing new equipment
F
or trouble-free and successful administration of inha- lation sedation, several basic recommendations should be followed prior to
initial installation of the equipment. Choices include: • Manufacturer: analogue or digital flowmeter
• Medical gas supply: pipeline system or stand-alone mobile four-cylinder stand
• Scavenging requirements: breathing system type/method of waste gas removal However, once specification is deter-
mined and equipment installed by a specialist company, then, with regular ongoing maintenance to ensure optimum equipment performance in accordance with manufacturer recommendations, most equipment of this category will offer the user many years of relatively trouble- free service. Indeed, there are a number of Cyprane Quantiflex flowmeters still in regular use more than 45 years after they were made in the ı960s and 70s at the factory, then located in West Lane, Keighley, West Yorkshire.
Inhalation sedation flowmeter types In the 2ıst century there is quite a choice of dedicated sedation flowmeters to choose from. And, in order to administer relative analgesia – or inhalation sedation – a dedi- cated flowmeter must be used.
Standards in Conscious Seda-
tion in Dentistryı states: “Dedicated purpose-designed Relative Analgesia machines for dentistry should be used. Such machines should conform to British Standards and be maintained according to manufacturer’s guidance with regular, documented servicing.” This statement is repeated in Conscious Sedation in the Provision of Dental Care published by the Department of Health in 20032 and remains the defining regulation in force. Flowmeters of this type have been
widely available in the UK since the ı960s. The Analogue MDM (Monitored Dial Mixer) is still the most popular type of IS flowmeter. Large quantities were sold and it is not uncommon to come across units that are more than 45 years old. The 2ıst century flowmeter model is the
Digital MDM, which also addresses the issue of infection control with its digital display and wipe clear touch screen. The current manufacturer is Porter Instruments USA, who purchased the Nitrous Oxide Sedation Division from Matrx in 2008. A variety of other flowmeter models are also available: Porter MXR C3000, Accutron Ultra, Newport and the McKesson Mcı. When choosing a flowmeter,
some thought must be given towards analogue or digital models. Elements to consider include: reliability, performance, available mounting and infection control. Thus, if infection control is a big issue, then the choice might involve the Digital MDM, Porter MXR or Accutron Ultra – all of
which were designed with this function in mind. Other considerations might include: • Type of flowmeter already familiar with • Whether to be used with pipeline or four cylinder stand
• General overall appearance • Space in surgery.
Medical gas supply options All of the above flowmeter types, with the exception of the Accutron Newport which carries integral mounting for four ‘E’ sized cylinders within its cabinet, require the addition of a medical gas supply, oxygen and nitrous oxide in order to function. The subject is divided into two main areas: Medical gas pipeline system: This is a
complicated area, with the main standard applicable being HTM 02-0ı published in May 20063. This best practice guid- ance is aimed primarily at hospitals and larger healthcare premises. It is very hard to apply successfully for smaller establish- ments. However, the basics required are: • Suitable location for larger cylinders • A piped system to carry the gases • At the surgery end, the pipework usually terminates in wall outlets (terminals) which are colour coded and gas specific for the oxygen and nitrous oxide, although a simple ‘in-surgery’ pipe- line system may not have these, being connected directly to the RA Flowmeter
• The price depends on type of pipework system and the number of outlets (surgeries) supplied. Mobile four–cylinder stand: This is a
combined mounting and medical gas system with a base and five legs (some older models have four), column and yoke assembly. The yoke carries a mounting
Scottish Dental magazine 55 Continued »
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