Nitrous Oxide


Clinical Indications:


  • Mild to severe pain
  • Patient must be able to self-administer the medication (i.e. be alert and oriented and capable of following instructions)




  • Previous eye surgery within the last three months, know allergy, significant head or chest trauma high clinical suspicion for pneumothorax or bowel obstruction.




  1. Connect Nitrous Oxide cylinder to regulator and turn on valve.
  2. Connect the green O2 tubing to O2 supply line.
  3. Open cylinder and ensure there is sufficient gas pressure
  4. Explain he procedure to the patient
    • This is a self-administered inhaled pain medication
    • Instruct the patient to place the mask over their face and take several deep breaths.
    • Repeat as needed to achieve maximum pain relief.
  5. Monitor the patient's self-administration of Nitrous Oxide
    • Monitor patient's mental status and level of pain
    • Place waveform capnography on patient by nasal cannula
    • Patients may require transition to oxygen supplementation upon discontinuation
  6. Document in patient care report (ePCR)
    • Document patients pain before and after Nitrous Oxide administration


Certification Requirements:


  • Maintain knowledge of the indications contraindications, technique and complications associated with the administration of Nitrous Oxide. Assessment of the knowledge and skill competency associated with this procedure may be accomplished via quality assurance , classroom demonstrations skills competency stations or other mechanism as deemed appropriate.
  • Nitrous Oxide may be administered by AEMT's and Paramedics, however, preference will be given to units where AEMT's are working as they do not have the same medication options as our Paramedics