Nitrous Oxide and Prehospital Emergency Medicine – Information Sheet for Emergency Care Providers

Nitrous oxide is a commonly used gas in prehospital and emergency settings in the form of a 50:50 mixture of oxygen and nitrous oxide, e.g. Entonox®. Used correctly, nitrous oxide can be a very safe and effective analgesic medicine. For some patients it may be the best option pain relief. However, there are broader implications of use of the drugs for both delivery of patient care, and the environment.

The NHS in England has pledged to be carbon net zero by 2040. The NHS is responsible for 4- 5% of total UK carbon emissions, and anaesthetic gases have been identified as a ‘carbon hotspot’.

This information sheet, put together with the College of Paramedics, Association of Ambulance Chief Executives, and the British Association for Immediate Care looks at the impact use of Nitrous Oxide has on the environment and what the alternatives are to its use.