Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Module 8 > SPECIAL CARE IV sedation > Flashcards

SPECIAL CARE IV sedation Flashcards

(52 cards)

Start Studying
1
Q

how is IV sedation delivered?

A

as an injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what drug is most commonly used for IV sedation?

A

Midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when is IV sedation used?

A

mild-moderate dental anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what state does IV sedation put the pt in?

A

amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

IV sedation indications?

A

dental anxiety/ phobia
medical conditions aggravated by stress
medical or behavioural conditions affecting the pts ability to co-operate
special care requirements
strong gag reflex
an unpleasant procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IV sedation contraindications?

A

needle phobia
medical reasons - allergy/ renal disease/ not medically fit
social reasons - single parent/ no escort
pregnancy
poor venous access

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

IV sedation equipment?

A

midazolam
flumazenil
labels for syringes
syringes
saline
pulse oximeter
BP cuff and machine
tourniquet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is saline used for in IV sedation?

A

to flush the canula at the start and end of sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does the pulse oximeter probe measure?

A

arterial oxygen saturation
HR
BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the sequence of events for IV sedation?

A

equipment checks
pre op and check in
confirm consent
draw up drugs
IV access
drug administration/ monitoring
titration
LA/ monitoring
treatment/ monitoring
recovery/ monitoring
discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the pre op equipment check for IV sedation?

A

oxygen cylinders full and tested
emergency drug box present and correct
monitoring equipment is working
dental equipment and suction working

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the set up for cannulation?

A

holder for breaking ampule
disposable 5ml syringe and green 21 gauge needle for drawing up the drug
disposable 2ml syringe for saline, water for injection
drug labels
alcohol wipes
22g canula
gauze
sterile tape
plaster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are your checks when drawing up the drugs?

A

check batch number and expiry date
label all syringes with to identify the drugs
note down the batch number and expiry date for all drugs drawn up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the drugs used for IV sedation?

A

midazolam 5ml ampule (1ml per ml)
sterile saline in 2ml syringe
flumazenil 5ml ampoule (100ug per ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what Flumazenil?

A

reversal agent for IV sedation
it should be used in a never event
it is a benzodiazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do you make your IV sedation pt comfortable?

A

adjust dental chair to semi supine position
reassurance
legs uncrossed to avoid venous stagnation and to make the pt more stable
attach finger probe of pulse oximeter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how do you select a vein for administration?

A

dorsum of hand/ antecubital fossa
pick a straight, thick vein: tap/ stroke vein, ask pt to open and clench fist
encourage vein to fill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what makes a good vein?

A

visible
palpable
long
wide
no infection in the area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the 3 main veins found in the forearm?

A

basallic vein
cephallic vein
median cubital vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what percentage CHX is in the 70% alcohol skin wipe?

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

stages of IV cannulation?

Study These Flashcards
A
  • swab skin with wipe
  • hold the hand firmly and stretch skin
  • cannula 22G
  • bevel up the way, 10-15 degree angle pierce the skin
  • primary flashback and secondary flashback observed
  • secure cannula
  • flush with saline
  • check for pain and swelling
22
Q

what is a sign that you have not cannulated a vein?

Study These Flashcards
A

pain and swelling

23
Q

what are problems with cannulation?

Study These Flashcards
A

difficulty locating
veins collapse
veins tissue
cannula kinks

24
Q

what is vein tissuing?

Study These Flashcards
A

you have cannulated vein but then you go out of the side of it

25
how is the midazolam administered?
slowly warn pt of a cold sensation tracking up the arm start with 1mg and wait 60 seconds further increments of 1mg given every 60 seconds gradually titrate until satisfactory end point
26
when do you emergency STOP administering midazolam?
if the pt complains of pain radiating down forearm or towards the fingers - this indicated accidental entry into artery
27
what are the increments of midazolam to give?
1mg
28
what is the max midazolam dose?
10mg
29
what are signs that you have reached the end point of sedation?
relaxed demeanor slowed response to commands slurring of speech eves sign remains responsive to verbal and physical stimulation
30
what is an unreliable sign of sedation end point?
Verrills sign - may indicate oversedation
31
what do you do once you have reached sedation end point?
flush through with saline
32
describe monitoring during sedation?
shared responsibility between sedation nurse and sedationisnt continuous and documented at the start of appt and every 5 mins pt appearance and behavour monitored (colour, breathing pattern, and position) monitoring machine (pulse oximiter): visual and sounds
33
what may stop the pulse oximeter from working?
dark coloured nail polish/ gel/ acrylic finger tapping/ playing with oximeter cold hands
34
what is normal saturation levels?
98% and above
35
when is prompt correction needed for sats?
when they drop below 96%
36
when is immediate action needed for saturation?
if drops below 90%
37
what are the warning signs on the sats machine?
pulse drop below 50 or rising above 120
38
what happens when saturation drops below 90%?
inhibited respiration or cardiovascular activity cardiac arrest, brain damage
39
what are the most common causes of o2 sats dropping below 90%?
resp depression breath holding oversedation
40
what do to when 02 sats drop below 90%
ask pt to take a few deep breaths if problem persists - 100% 02 via nasal cannula at 2-4l/min
41
what to do if there is persistent 02 saturation below 90% that is not corrected by breathing and giving 02?
reverse sedation with flumazenil bag and mask ventilation call 999
42
what may happen if pulse drops below 50 (bradycardia)?
vasovagal attack/ vagal stimulation or hypoxia
43
what may result in tachycardia (pulse above 120)?
anxiety, inadequate anaesthesia and/or poor pain control
44
how long is sedation time with IV?
30-40 mins
45
what may you need to use during treatment under IV sedation?
mouth prop - due to muscles relaxing
46
how do you know if a pt is over sedated?
they are asleep/ cannot communicate
47
airway considerations with IV sedation?
benzodiazepines cause some depression of protective reflexes and some degree of resp depression careful aspiration and retraction to protect airway secure cotton wools with floss count cotton rolls rubber dam for endo keep an eye on sp02
48
what is done at the end of the dental procedure under IV sedation?
return pt to upright position ensure pt can stand escort pt to recovery room pt should be directly supervised by a member of dental staff continue to monitor
49
who do you give POI to?
the escort
50
POI for IV sedation?
restful day no alcohol, driving, operating machinery, cooking, boiling kettles, signing important documents for the rest of the day
51
explain the discharge procedure for IV sedation?
at least 1 hour must have elapsed since last increment of drug administered before the pt can be discharged pt must be able to stand and walk without assistance final BP should be taken venous canula should not be removed until pt ready to be discharged pt and escort must leave together
52
what must be written in notes after IV sedation?
names of those present drugs administered (dose, batch number, expiry date) record that consent was obtained and for what tx describe the work undertaken in the usual way record the quality of sedation and any adverse reactions (emotional and physical) record that POI were issued and arrangements for follow up car e

Module 8 (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions