General sedation knowledge Flashcards
(20 cards)
What is intravenous sedation?
Muscle Relaxant, rapid onset of around 20 seconds, anticonvulsant
What drug reverses the affects of Midazolam and what dosage would be given?
Flumazenil 200mcg over 15 seconds, further 100mcg after - no more than 1mg total.
Can a habitual recreational drug user by treated with IV?
no, it is not suitable for recreational drug users.
When administering N2O, what percentage would you start at?
10% Nitrous, 90% O2, increase by 5-10% each time.
What are the signs of over sedation with IS?
Nausea, Giddiness, blue lips and finger tips, wheezing, dissassociation
What equipment would you set up for IV?
- Nasal cannula for supplimentary, pulse oximeter and BP machine
- 5ml syringe labelled Midazolam
- 10ml syringe labelled saline
- 10ml of saline
- torniquet
- 21G draw up needles
- 5ml syringe labelled Flumazenil,
- tegaderm dressing
- cannula
- Ampoule breakers
- drugs
Providing inhalation sedation for anxious patients can be very demanding and requires the dental team to focus a lot of their attention onto the patient. At these times it can be difficult to constantly monitor the sedation machine and the supply of gases. If the oxygen supply were to empty the patient could be exposed to very high levels of nitrous oxide leading to loss of consciousness and severe hypoxia. The safety feature which most significantly manages this risk is?
Automatic Nitrous Oxide cut off, highest NI you can give is 70%
Appointments to provide treatment under inhalation sedation are often quite long. The sedative gas is inhaled and then exhaled unchanged. Staff exposed to low levels of nitrous oxide can experience temporary disorientation and overtime have harmful effects. The safety feature which most significantly manages this risk is?
Active scavenging
Patients under inhalation sedation tend to be calm and relaxed. Despite this at certain points during dental procedures the patient may become suddenly stressed and start to take rapid deep breaths. If the flow rate is set too low, then the reservoir bag could empty, and the patient feels like they aren’t getting any gas through the nasal mask leading to more stress. The safety feature which most significantly manages this risk is?
Air Entrainment Valve
Many of the features of an inhalation sedation machine are designed to prevent the patient being exposed to unacceptable high levels of nitrous oxide. If the nurse tried to place a nitrous oxide cylinder on to the oxygen attachment, these features could be by passed. The inhalation sedation machine has a feature to physically prevent this. The safety feature which most significantly manages the risk is?
Pin Index System
Some surgeries have piped gas supplies. The inhalation machine does not have cylinders hanging from it, instead it is connected to fittings on the surgery wall. If the dental nurse was confused and inserted the oxygen pipe into the nitrous oxide supply the patient could be exposed to very high level of nitrous oxide. This could lead to loss of consciousness and severe hypoxia. The safety feature which most significantly manages this risk is?
NIST connectors
Oxygen is stored in cylinders at 2,000 pounds per square inch when full. If a patient where exposed to this gas then their lungs could be severely damaged. The inhalation sedation machine includes a device which is able to prevent this valve of gas escaping only allowing a safe amount of gas to be carries to the patient. Which safety feature is being described?
pressure reducing valves
Which of the following features would allow the patient to breathe atmospheric air if the flowrate were
set too low?
Entrainment Valve
A student dental nurse that you work with has heard that intranasal sedation can be a useful method
for administering sedative drugs for patients with special needs. They ask which drug would be given
by this route. What is the correct response to this question when following current UK guidelines?
Midazolam
Some medications are classified as controlled drugs under the misuse of drugs legislation. Many of
the drugs which may be used in conscious sedation fall under this control. Which of the drugs in the
list below is not categorised as a controlled drug.
Flumazenil
The body mass index may have been used to indicate if a patient is suitable for conscious sedation within a
general dental surgery. How is the BMI calculated?
Mass (kg) ÷ Height (m)²
If a patient
was exhibiting the sign of ‘cyanosis’, which of the following changes is most likely to have occurred?
Decreased respiration rate
During the recovery of a patient who has had Intravenous Sedation, the dental nurse should
undertake several observations to ensure the patient is fully recovered. Which of the following should
the dental nurse ensure takes place during recovery?
Clinically monitor the patient throughout
recovery
The respiration rate of a resting adult is?
12 - 20 breaths per minute
Drugs administered via the sublingual, buccal, intranasal and rectal routes are all absorbed across a
mucosal surface. What is this absorption route?
Transmucosal
