sedation midterm 2 Flashcards
(36 cards)
Above which BP number do you not do elective dentistry on?
165/95
What are the 2016 ADA revisions?
1) Mandate Capnography (expired CO2) for moderate sedation to general anesthesia but NOT FOR MINIMAL
2) States BMI and sleep apnea should be screened for BEFORE sedation (Yes minimal)
What is the best functional test for ASA?
Walking up a flight of stairs
What is the best instrument for ASA determination?
Spirometer too look at oxygen consumption. The more oxygen you can burn, the better your cardiovascular health
What is safer than general anesthesia that is gaining more use these days?
Why?
Sedation with local anesthesia
General anesthesia is taxing on the body and you can lose patients just by that process itself. Now days, LA + sedation is preferred for those patients due to decreased mortality
What is an ASA 6 patient?
HEALTHY people that might have some brain injury – now they’re donors
In what group of patients is a LOW BMI dangerous?
OLD people and little kids failing to thrive
People with capacities of _____ METS or less are at high risk for medical complications
4
*10 METS or more is very low risk
f someone has been fighting high blood pressure their whole life, and then suddenly, we see a decrease, do we celebrate?
Nah, they’ve probably got Heart Failure. Things are bleak fam
What does sedation do to BP?
sedation lowers BP
another name for valium?
moderate dose?
diazepam (which lowers BP)
- generic name
- moderate dose of 10mg
Does lidocaine, in high doses, sedate the brain?
yes
What is the gas in australian?
Methoxoyflurane
Before you get a patient to do drugs, what do you need first?
1) informed consent not while under influence
2) signed consent
What is the ONE drug you don’t need a designated driver for?
Nitrous oxide (N2O)
1) What is the best route of drug administration?
2) Second best?
1) IV
2) gas inhilation
What hair color is harder to sedate?
Midazolam appears to cause significant less sedation and cognitive imparement in red haired subjects
How does ethyl alcohol absorption get affected by food vs no food?
Think about that one time you slammed 4 white class with no food vs when you do pizza and beer, and kill the whole 6 pack
Why should states consider dropping the permit for sedation?
RISK of sedating a patient with nitrous oxide/oxygen alone is LESS than not sedating the same person
What is the fentanyl patch? Can it kill you? What increases the absorption rate?
opiod patch for pain
- Yeah, ROA has no administration on concentration. Fenty causes resp depression
- heat speeds it up
What do sedation agents hit first – what aspect of the patient? how to assess?
Their CNS
*** A patient should be able to talk and respond when commanded if conscious
name 3 sedation scales
1) University of Michigan
Sedation Scale (UMSS)
* 0 is awake, 4 unarousable
2) Responsiveness Scores of the Modified Observer’s Assessment of Alertness/Sedation Scale (OAA/S)
* 0 no response, 5 responds readily *subjective
3) Bispectral analysis (BIS)
* OBJECTIVE * determines the patient’s sedation based on EEG *N2O doesn’t register
What is OAA/S?
This is a responsiveness scale of a patient post sedation. It’s not perfect and is subjective !
Responsiveness Scores of the Modified Observer’s Assessment of Alertness/Sedation Scale (OAA/S)
* 0 no response, 5 responds readily
Bispectral analysis (BIS) vales for: Light to moderate sedation, Deep sedation, General anesthesia and Hypnotic state
Light to moderate sedation 70-90
Deep sedation 60-70
General anesthesia 40-60
Hypnotic state 40-lower
