Training Bulletin 62 4/2001

Nitrous Oxide & Oxygen (No2+O2 gas) Hazard:

Caisson’s disease in the newborn.

  More isolated incidents have occurred in another part of the NHS. The purpose of this bulletin is to bring them to the attention of staff.

London Ambulance Service NHS Trust fully supports the rights of women to elect for a home birth, and crews should be aware that a birthing pool is an increasingly common.

Problems have been experienced however with the deeper pools, and in certain cases, babies born at depths of more than 50 metres whose mothers have received large quantities of N02+O2 gas have experienced symptoms of Caisson’s disease (the “bends”) on resurfacing.

Nothing in this notice suggests that there is anything wrong with excellent products like Entonox® or Nitronox® but advice taken from WADI, the World Association of Diving Instructors, would suggest that the speed at which the new-born surfaces should be slow and gradual, especially between the critical 30>20 metre depths. This is particularly important if the new-born is a baby buoy.

Crews facing a deep pool birth scenario should request the attendance of the duty manager and a SCUBA unit.

Further silly advice can be found at www.lasunofficial.co.uk

London Ambulance Service NHS Trust

Inexplicably & Suddenly Retired Department

Dole House

Benefit Street

Cadger-on-Scrounge

GR33 NUP