Child Life Corner
Tips and Techniques: The Face Mask and Applications for Nitrous Oxide
By Kris Murray, CCLS
Section Editor
Nitrous oxide is a great addition to sedation programs to help kids with their medical procedures. When it works, it works! However, there are times when kids don't like the mask. It could be they've had a negative experience in the past, they may have sensory issues to touch or smell or it's a new experience.
The first step is to assess if there are issues with a mask and from there an approach can be determined. If there are sensory issues to smell or touch, nitrous may not be an option for that child. Explore the degree of their sensitivity with the parent and child and the probability of accepting the mask.
It will be important to give the child control by using medical play and a slow approach. This could make a difference in their acceptance of the mask.
Below are some techniques to use when introducing the mask:
- While talking with the child and family, hold and play the mask without talking about it.
- When introducing the mask, avoid putting the mask on the child's face right away.
- Use "soft words" to describe the mask, such as soft, squishy, it doesn't hurt and can smell good.
- Use "soft words" to describe why they will wear the mask such as, "so you can smell a special strawberry air to help them relax". "It makes some kids giggle".
- Ask if they'd like to touch it or hold it. If they don't, have the parent hold it and play with it.
- Give the child a choice of which scent they would like in their mask.
- Ask the child if the mask smells good - they will often put the mask up to their face to smell it. If they are still hesitant, have the parents smell it and/or put the mask on their stuffed animal or doll (if they brought one).
- Give a mask to their parent or stuffed animal so they each have one.
- Have the child personalize their mask by decorating it with stickers.
- If the child remains apprehensive of staff, leave the mask in the room for the parent and child to play and practice wearing the mask.
- Use "soft words" to describe the nitrous machine, such as "this is where the strawberry smell comes from" and when describing the tubing that holds the mask, "this tube holds the mask so we can play".
- Make a "Coping Plan": where will the parent be, what is the child's job (wear the mask and breathe the special air and any other directions to complete the procedure like holding their arm still) and decide what they'd like to play with. Practice taking slow deep breaths.
The Use of Nitrous Oxide
- Initiate the coping plan/play before placing the mask.
- Tell the child it's time to smell their special air.
- Put a towel on the child's head to avoid their hair being pulled by the tubing.
- Ask the child to help you with the mask.
- Slowly bring the mask to the child's face.
- If the child is hesitant to put the mask directly on their face, place the mask close enough with nitrous oxide running for them to begin to relax and accept the mask (tip from a medical practitioner).
- Make sure they can see the distraction item.
- Remind the child to take slow, deep breaths.
- Create a calm environment with limited noise and one person talking to the child at a time.
If the child still doesn't like the mask and they will be returning, send a mask home for them to play with at home.
