SEDATION/CONSENT - STATION 2 Flashcards

Question

what equipment is needed for IV sedation

Answer 1

1. Midazolam 2.Flumazenil 3. Labels for syringes 4. Saline - sedation usually accompanied by hypotension, which reduces the amount of sedation able to be employed. Blood pressure is restored by the infusion of intravenous normal saline. 5. pulse oximeter 6. BP cuff and machine 7. Tourniquet

Answer 2

nail polish (dark)/gel/acrylic nails finger tapping/playing with pulse oximeter breath holding cold hands fasting - varies between units

Answer 3

1. loss of protective reflexes 2. loss of consciousness 3. decreased respiration 4. decreased heart rate

Answer 4

never event

Answer 5

it is a benzodiazepine

Answer 6

usually midazolam delivered as a drink

Answer 7

must still cannulate for safety - rescue/reversal must be proficient in IV technique

Answer 8

Oral sedation means that the sedation drugs are swallowed as a tablet or liquid. It takes about 10 minutes for the effects of the drug to work. Once you are sedated, you will usually have a small cannula placed in the back of your hand or in your arm

Answer 9

5 - 10 mg Diazepam Last thing at night on the evening before the appointment On wakening on the morning of the appointment 60 - 90 mins before the appointment Prescribe only what is required

Answer 10

2, 5, 10 mg tablets for oral use

Answer 11

Very anxious patients – may aid them attending the surgery or sleeping the night before Patients when sedation is contraindicated:- Medical reasons Inability to get venous access – IV Sedation Inability to breath through nose – RA To “take the edge off” before more complex and prolonged procedures

Answer 12

Hepatic impairment Renal impairment Pregnancy Breast feeding

Answer 13

Avoid prolonged use Reduce dose in debilitated patients Reduce dose in elderly Respiratory disease Patient compliance – taking at wrong time!

Answer 14

IACSDS interollegiate advisory committee for sedation in dentistry standards

Answer 15

A general anesthetic is a state of controlled unconsciousness, affecting the whole body, so the patient does not move or feel pain, with loss of protected reflexes

Answer 16

Lengthy or complex surgery Very anxious / dental phobic patients who are unable to tolerate / cooperate with treatment under other modalities e.g. LA, oral, IV or nitrous oxide sedation Patients with a profound learning disability who are unable to tolerate / cooperate with treatment under other modalities e.g. LA, oral, IV or nitrous oxide sedation Multiple extractions in multiple quadrants Severe trauma or acute dental infection Cases where nitrous oxide or IV sedation is contraindicated or inappropriate

Answer 17

Patient cooperation not required* Patient unaware of the procedure taking place Significant amount of treatment can be carried out in one attendance May be able to co-ordinate interventions with other specialities

Answer 18

‘Open’ consent often needed as cannot change the treatment plan half way through, or wake patient to discuss, e.g. “EUA – examination under anaesthesia and dental treatment as deemed appropriate”. Some patients not happy to give ‘open’ consent which could result in e.g. more teeth extracted than first anticipated, or front teeth needing extraction

Answer 19

Preoperative assessment(s) medical and dental needed Needs careful treatment planning / all work to be done in one visit, Treatment often has to be more radical to be done in one visit Does not help the patient get over their fear / build confidence Pre-op fasting and after care required Risk (morbidity and mortality) of GA

Answer 20

Conscious sedation, depression of consciousness, patients respond purposefully to verbal commands

Answer 21

nearly unconscious, only has purposeful response to repeated and painful stimulation.

Answer 22

completely unconscious, does not respond to any level of pain. The patient will require breathing assistance and cardiovascular function may be impaired

SEDATION/CONSENT - STATION 2 Flashcards

(50 cards)