RESOURCE UTILIZATION REQUIRED FOR THE USE OF PREMIXED NITROUS OXIDE IN OXYGEN INHALATION IN A LARGE PAEDIATRIC HOSPITAL SETTING

International audiencePremixed nitrous oxide (NO) in oxygen is an inhaled gas that is widely used for pain and anxiety management during minor procedures for children. Its rapid onset of action and recovery make NO an attractive option especially in emergency rooms (ER). However, its administration requires a specific organization, notably the involvement of a secondary caregiver specifically dedicated to hold the mask. Literature lacks of data that measure resources specifically devoted to a NO inhalation. We aim to start filling this gap by highlighting the organization and the costs that are necessary in putting in place a treatment by NO in a large paediatric hospital in France.A prospective observational study was conducted from the hospital’s perspective at Robert Debré university hospital (Paris). Our inclusion criteria were children aged from at least 6 months who were presented at the ER in 2015 and to whom NO had been prescribed. We measured the time of the NO inhalation and the time spent by the medical or informal caregivers. Then, we estimated the total cost of the inhalation by patient (time, gas, accessories).The studied sample included 30 children from 1 to 14 years old. In 70% of all cases, a secondary caregiver was required depending on the child’s agitation and anxiety. In 57% of these cases, this help was provided by a member of the medical staff (student or not), otherwise the parents have assisted the child. Our results underline that supplementary medical time is an important part of the cost component (from 10% to 32% depending various scenarios) and would increase if more qualified medical staff had been involved against informal caregivers.Regarding the cost component’s structure, the research of alternative therapeutic options is still relevant for pain and anxiety management during minor procedures for children