We have recently received several questions regarding the use of nitrous oxide in QUAD A facilities.
The use of Nitrous Oxide in QUAD A facility classes B, C-M, and C is permitted; however, the safety requirements listed in 1-A-12 and 4-C-16 below must be met for the administration and the delivery system:
1-A-12: In this facility, operations may be performed under:   
Nitrous Oxide, which may be administered by any of the following:   
- Anesthesiologist   
- Certified Registered Nurse Anesthetist (CRNA) under physician supervision if required by state/local law   
- Anesthesia assistant as certified by the National Commission for the Certification of Anesthesiologist Assistants (NCCAA) under direct supervision of an anesthesiologist   
- Registered nurse under the supervision of a qualified physician
4-C-16: If nitrous oxide alone is used, then a safe delivery system is used.  A safe delivery system meets the following criteria:   
- Alarms   
- Gas scavenging   
- Color coding of tanks, knobs, and hoses   
- Diameter index safety system for non-interchangeable connection of gases – pin index safety system   
- Oxygen fail-safe system and oxygen flush capacity   
- Quick connection for positive-pressure oxygen delivery   
- Emergency air inlet   
- Reservoir bag   
- Storage in secured area  
Thank you for choosing QUAD A. If you have further questions, please feel free to submit them to standards@QuadA.org
We appreciate your commitment to patient safety.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come fi
