Checklist for setting up Nitric Oxide (NO)
1. Collect cylinder and ensure that it contains 1000ppm NO in
nitrogen, check label attached to
2. Check cylinder is turned off then
attach regulator to cylinder and make sure it is tight. If
3. Take cylinder to bedside and attach regulator to flowmeter, ensure flowmeter is switched off.
4. Make sure cylinder is secured to a wall or
trolley - falling cylinder may cause injury or result
5. Turn on cylinder (and if applicable,
regulator) and check for leaks around cylinder head,
6. Using regulator gauge nearest cylinder check there is sufficient
gas supply in the cylinder (see
Attach NO delivery tubing to flowmeter output but not to ventilator circuit.
-If the required ventilator is not in use then at the end of the set-up a
test lung can be
IF HIGH NO
FLOWS ARE USED FOR PURGING THEY MUST
9. Connect the flowmeter output tubing to the ventilator, and the monitoring
tubing to the NO/
10. Attach scavenger system to the ventilator exhaust.
11. Turn on NO/NO2 analyser.
12. Set the NO flowmeter to the level required, calculated using the formula:
13. Make sure regulator and cylinder are turned
on and if required the output pressure is adjusted
14. Allow the analyser a few
minutes to settle, then adjust the NO flow as necessary to give the
15. Set up a hand ventilation circuit as per policy of individual unit.
16. Make sure there are
spare cylinders easily to hand to swap with the ones in use when
17. Check a methaemaglobin level after 1 hour and then every 12 hours.
18. Monitor NO dose on analyser-adjust flow to maintain desired dose.
19. Monitor NO2 reading on analyser. High readings may be due to inadequate purging.
20. Ensure environmental
monitors are working - maximum recommended levels are 25ppm of NO