Administering Entonox for Pain Relief

Scenario: Dan's Dislocated Patella

Dan has dislocated his left patella and is experiencing severe pain while awaiting emergency services.

Initial Assessment and Pain Score

Assessment and Pain Evaluation:

• Before administering Entonox, inquire if the patient has used it before.
• If it's their first time, provide guidance about potential side effects.
• Conduct a pain score assessment on a scale of 1 to 10 to establish a baseline.
• This baseline will help monitor the effectiveness of Entonox.

Administering Entonox

Safe Administration:

• Open the Entonox kit, take out the giving set, and the gas bottle.
• Turn on the gas bottle and insert the Schrader valve, ensuring it locks securely.
• Attach a one-time-use mouthpiece to the regulator or giving set.
• Ask the patient to place the mouthpiece in their mouth and inhale deeply while continuing to suck.
• Explain that they may feel light-headed; Entonox takes about 4-5 minutes to take effect and up to 10 minutes to peak.
• Monitor the pain score as they continue to use Entonox.

Monitoring and Documentation

Continuous Monitoring and Record Keeping:

• Stay with the patient until emergency services arrive.
• Continue assessing the pain score and note any changes.
• Document the start time, finish time, initial pain score, and pain score at handover to ambulance crew.
• Provide verbal handover of Entonox administration to the ambulance crew.