Pro-Nox Comfort Zone Resource Center

See Pro-Nox User Manual for full details.

Attach patient circuit to Mixer unit, ensuring the large round filter end is connected to the Pro-Nox intake located at the center of the Mixer. If using a scavenger, follow the specific scavenger Instructions for Use to connect it to the Pro-Nox.

Confirm gas tank hoses are securly connected to Mixer. Use the cylinder wrench to open the gas tanks (counter-clockwise), starting with Nitrous Oxide (N2O) first. The Pro-Nox alarm is activated by Oxygen (O2). Once the Oxygen tank is open, the Pro-Nox will alarm once.

Ensure Mixer unit switch is turned to “ON”.

Have patient hold the circuit hose and maintain a seal with mouthpiece or mask while breathing in and out. Effects can occur within 30-90 seconds.

See Pro-Nox User Manual for full instructions and contraindications.

Discard circuit hoses, mouth or mask pieces and filter(s) after each patient.

To shut down the Pro-Nox, use the cylinder wrench to close (clockwise) the Oxygen (O2) tank first, followed by the Nitrous Oxide (N2O) tank. Then turn Mixer unit switch to “OFF”, as shown above.

Wipe down the Pro-Nox system.

See Pro-Nox User Manual for full care details.

Please check out the video below to assemble your Pro-Nox Rollstand Base.  Click here to view the assembly guidebook.

Click here to view the assembly guidebook.

Safety Features

• The delivered gas mixture is pre-set at 50% Nitrous Oxide (N2O) and 50% Oxygen (O2). Neither the patient, nor medical personnel, are able to adjust this ratio, eliminating the risk of delivering a hypoxic mixture.
• The gas-specific built-in alarm systems will generate both visual and audible alarms should either the N2O or O2 source pressure fall below 40 PSI, and the demand valve will no longer activate should either the nitrous oxide or oxygen source pressure fall below 35 PSI.
• The device is also equipped with a secondary “fail safe” circuit that will activate a continuous audible alarm and disable the demand valve should internal malfunction occur in the mixer or any internal hoses rupture or kink.
• Gas Supply Visual Indicators, located on the front panel, the O2 visual indicator shows green when Oxygen is supplied to the unit at a sufficient pressure, and the N2O visual indicator shows green when Nitrous Oxide is supplied to the unit at a sufficient pressure. Used in conjunction with the low supply (input) pressure alarms, these indicators provide additional reference for the operator as to the gas supply status.

Low Input Pressure Alarms

• At any time, if the input pressure of either gas drops to 40 PSI, a visual and audible Low Input Pressure Alarm will be activated. The alarm will cycle 45 to 75 times per minute for N2O, or 90 to 150 times for O2 and both gas supply indicators will flash green.

Low Input Pressure Shut-Off

• The demand valve will no longer activate if either N2O or oxygen source pressure falls below 35 PSI. This indicates that the source gas is now exhausted to the point where the device will no longer function as indicated. The patient will draw ambient air via the port on the back of the machine.
• As the O2 source pressure drops below 35 PSI, the demand valve shuts down and the O2 supply indicator will go from flashing to ‘off’. The audible alarm ceases. The N2O supply indicator will remain ‘on’.
• As the N2O source pressure drops below 35 psi, the demand valve shuts down and the N2O pressure indicator and audible alarm continue to cycle. The O2 supply indicator will remain ‘on’. The low N2O alarm will continue until the O2 supply is depleted or disconnected.

Active Scavenging System

• The waste gas scavenger is designed for use with wall suction and employs a reservoir canister with open relief ports to efficiently remove waste gas and maintain a neutral pressure on the system.
• An adjustable vacuum control valve regulates active vacuum to provide user variable waste gas disposal flow, which is indicated on an uncalibrated flowmeter.

Protection from Infection

• Internal demand valve mechanism prevents contamination of the reusable components of the system.
• Single-use patient circuit means every patient starts with a clean piece of equipment.
• One-way valve in the patient circuit prevents contamination of the mixer.
• Filter built into the patient circuit protects against machine contamination in the event the one-way valve fails.

See Pro-Nox User Manual for full features.

The Pro-Nox manufacturer recommends the following user-led Preventative Maintenance to ensure your system remains safe and fully operational:

Every 6 Months- User review (per Manual Section 4.3):

• Visual Inspection (Monthly): Ensure the device is in working order, gas tanks are full, and all components are present.
• Leak Test (Biannual): Check for any gas leaks in the system.
• Function Check (Biannual): Verify proper demand valve operation,  alarms, and low-pressure shut-off functionality.

Annually – Professional Maintenance:

• Service Level II: This comprehensive check evaluates all internal components and functions. It must be performed at the CAREstream Service Center

As a Pro-Nox Comfort Zone, CAREstream America offers both Annual Preventative Maintenance and Extended Service Plans to support the continued care of your device mixer (the head unit on top). Our programs are designed for convenience and efficiency – so your daily practice remains uninterrupted.

Click below to view your service options. Page 2 includes a quick form to get started.

Click to View Our Pro-Nox Service Programs

We’re here to help – please don’t hesitate to reach out with any questions.

Oxygen (O2) and Nitrous Oxide (N2O) gases are very different. Review the information below to understand the characteristics of these gases separately and how they work when connected to a Pro-Nox 50/50 fixed gas delivery system.

Oxygen

• Oxygen is a compressed gas.
• An E-cylinder holds approx. 625 litres.
• A full cylinder has a pressure of 2200 psi.
• The psi drops as you use the gas.
  • This is handy, as you know that a cylinder that has 1100 psi left is half full (about 310 litres left).

Nitrous Oxide

• Nitrous oxide is a liquid with compressed gas on top.
• As you use the gas, the liquid below evaporates to replace it.
• An E-cylinder hold approx. 1590 litres of gas.
  • **This is 2.5 times the amount of oxygen held in the same size cylinder.
• A full cylinder has a pressure of approx. 750 psi. Because new gas keeps evaporating and taking the place of the gas being used, the pressure in the cylinder does not drop until the liquid is all gone. This leaves a cylinder with 750 psi of gas (about 230 litres).
• At this point the nitrous oxide acts just like oxygen, so as you use the gas, the pressure drops.

Preventing running out of gas
One study measuring gas usage by L&D patients breathing nitrous oxide/oxygen mix showed an average of 400 litres of the mixed gas was used per patient. This is 200 litres of oxygen and 200 litres of nitrous oxide. You should be able to offer the PRO-NOX to 2 or 3 ‘average’ patients before the oxygen cylinder needs to be changed. The nitrous oxide cylinder will last for approx. 7 patients before it needs to be changed.

As a general rule, after a patient is finished with the PRO-NOX (or if the patient has been using the PRO-NOX for more than 3 – 4hours), consider changing either cylinder if the pressure is less than 500 psi. This should prevent the cylinder being drained to the point of triggering the PRO-NOX alarm and requiring a change in the middle of a delivery.

Safety

Always handle gas cylinders with care, and ensure they are properly secured when in use or in storage.

Always keep the nitrous oxide cylinder upright or near-upright to ensure the gas layer on top is the stuff getting to the PRO-NOX. If you use the nitrous oxide cylinder while it is lying on its side, you can end up with liquid in the regulator and hoses, which is bad for both machine and patient.

The Pro-Nox system alarms will sound when a gas cylinder is low.  Review these steps to change out your tank. To resupply your gas, please contact your local supplier.

1. Use the cylinder wrench to turn the yoke valve clock wise to firmly close the low cylinder. If your nitrous runs out, you must also close the oxygen tank. Otherwise, the alarm, which is powered by the oxygen, will continue to sound until a new nitrous tank is installed

2. Turn the regulator T-bar counter-clockwise to loosen the regulator from the cylinder. Lift the regulator off the yoke. Ensure the regulator still has the washer (bodok seal) around the gas inlet and is still intact.

3. Remove any protective wrap from around the yoke of the new cylinder before replacing. See example above of plastic cover to be removed.

4. Place the regulator over the yoke of the new cylinder, lining up the index pins and gas inlet to they slide into their receiving holes.

5. Hand tighten the regulator T-bar so the regulator is firmly attached to the cylinder yoke.

6. Use the cylinder wrench, slowly open the cylinder yoke valve by turning it counter-clockwise until you encounter resistance. Do not force the valve beyond this point.

7. If both cylinders were closed, open the N2O cylinder first to prevent unnecessary audible alarms.

8. Listen for leaks at the yoke and at either end of the tank hoses.

9. Check the supply pressure indicators on the front of the Pro-Nox Mixer. Both indicators should be green.

Resume using your Pro-Nox System. See Pro-Nox User Manual for full care details.