Inhalation Sedation Equipment

There are currently approximately seven main types of dedicated inhalation sedation flowmeter in circulation on the UK and Irish market. These include:

• MDM (Cyprane, Fraser Sweatman, Matrx) — the traditional analogue flowmeter. Workhorse of UK dental sedation.
• Digital MDM (Matrx) — same physical design as the analogue MDM, with an electronic flow display.
• MXR (Porter) — a continuous-flow flowmeter common in the US, also sold in the UK.
• Quantiflex Mark II (Cyprane, Fraser Sweatman) — older analogue design, declining in use.
• Ultra and Newport (Accutron) — Accutron Newport is floor-standing.
• Mc1 (McKesson) — older design.
• Quantiflex Mark I (Cyprane) — older still, rare now.

All these units require some form of mounting to hold them at the correct operating angle, with the exception of the Accutron Newport which is floor-standing.

Flowmeters can be supplied with gas from:

• Cylinders on a four-cylinder stand — the traditional setup. Two oxygen and two nitrous oxide cylinders, with automatic changeover when one pair runs low. Still common in practices that want independence from the pipeline.
• Piped medical gas — oxygen and nitrous oxide delivered through a dedicated pipeline from a central bank. Requires a pipeline system installed to HTM 02-01.

For new-build practices, piped gas is increasingly the standard. For existing practices, a four-cylinder stand remains a reliable, lower-capital-cost option.

When specifying a pipeline, work with an HTM 02-01-compliant installer. R A Medical can advise on pipeline sizing and terminal placement — call Janet on 01535 652 444.

A scavenging system that delivers 45 L/min at the nasal mask is the standard. The three methods are:

• Connection to a high-volume dental vacuum (subject to it being externally vented).
• Connection to a centralised AGS system with no air break in-line.
• Connection to a Miniscav standalone unit.

For most practices, a Miniscav is the simplest, most reliable option. It is independent of the surgery vacuum, delivers a consistent 45 L/min, and works with any standard breathing system.

Make sure your scavenging system is included in your annual equipment service. R A Medical services Miniscavs and most other makes.

Your equipment maintenance programme should include:

• Pre-use checks — every day, by the clinician or nurse using the equipment. Documented on a checklist.
• Quarterly checks — by a designated team member. Includes visual inspection of the breathing system, the reservoir bag, and the pipeline connections.
• Annual service — by a trained engineer. R A Medical offers both on-site engineer visits and a postal service (3-day turnaround). All work is to OEM specification using genuine parts.
• 6-year regulator and hose replacement — per MHRA guidance and manufacturer recommendation.
• Decontamination log — every cycle documented.

A well-maintained flowmeter will give 15–20 years of service. A neglected one fails prematurely and expensively.