Special Care and Conscious Sedation Flashcards
what problems can their be in providing dental treatment to someone who requires special care
communication
anxiety
moving target
perception of reality
previous experience
what movement disorders can make dentistry tricky
muscular dystrophy
cerebral palsy
MS
parkinsons
huntingtons
what do you assess with someone who has movement disorders
anxiety
mental and physical status
pain experience
what learning difficulties can make dentistry tricky
congenital
trauma related
infection related
CVA
alzheimers
what do you assess for managing people who have learning difficulties
will behaviour management be possible
is pharmacological management needed
sedation or GA needed or both?
what issues can we have with consent with people with learning difficulties
no one else can consent to sedation
need signed consent from the individual
patient is competent but cannot write
how would you deal with an adult who is competent to consent but cannot write to sign the sheets
document the verbal consent in the notes and why they could not sign the papers
how can we deal with capacity to consent issues
follow the AWI act and do the training to get the certificate
what conscious sedation techniques are available
inhalation
intravenous
oral
transmucosal
what influences your choice of sedation technique
patient co-operation
degree of anxiety
dentistry required
skills of the dental team
patients previous experience
facilities available
anaesthetist required
what are the advantages of inhalation sedation
useful for anxiety relief
rapid recovery
flexible duration
what are the disadvantages of inhalation sedation
keeping nasal hood in place
less muscle relaxation
coordination of nasal breathing when mouth open
what are the advantages of IV sedation
good sedation achieved
less cooperation needed
muscle relaxation
what are the disadvantages of IV sedation
baseline readings
IV cannulation required
assessing sedation level
behaviour during recovery
efficacy swallowing
what are the advantages of oral and transmucosal sedation
avoids cannulation
can make induction more pleasant
better cooperation
better future behaviour
