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N2O/O2 CONSCIOUS SEDATION: Progress Notes Name Date Patient Informed Consent: NIL BY MOUTH FOR 2 HOURS prior to sedation MH Review CONTRAINDICATIONS TO N2O? Respiratory Infections Sinus/ Nasopharyngeal Obstruction COPD Ear Infection / Middle Ear problems Psychiatric or Personality Disorders Colostomy Other Medical Conditions/Medications SURGERY IN THE LAST THREE MONTHS? Eye Surgery (especially retinal surgery). Ear Surgery Abdominal (especially endoscopic) Other: Pre-Op Vital Signs: B/P ______/_____ Hg mm Pulse______/min Resp______/min Pre-Op 100% O2 administered for 5 minutes TITRATION: Administered by: Time:_______am/pm______% N2O______% O2 Time:_______am/pm______% N2O______% O2 Time:_______am/pm______% N2O______% O2 Time:_______am/pm______% N2O______% O2 Vital Signs: B/P ______/_____ Hg mm Pulse______/min Resp______/min Observations: Colour Resp Pupils N2O/O2 Total Flow Rate______Litres/min for _____minutes Post-Op 100% O2 administered for 5 minutes Post-Op Vital Signs: B/P ______/_____ Hg mm Pulse______/min Resp______/min Patient ALERT and ORIENTATED upon dismissal Post-Op Instructions given: Written Verbal Notes: Normal Values (adult ): B/P <120/80mmHg Pulse: 60-100/ min Resp: 15-20/min FBS: 3.6 -5.8 mM