5 - Assessment for IV sedation Flashcards
1
Q
Describe the assessment appointment for sedation?
A
- separate visit
- baseline tests
- clear communication about what to expect and how to prepare
- can give patient written information
2
Q
What are the steps of the assessment appointment?
A
- history (social, dental and medical)
- exam (general, oral, vital signs)
- tx plan
- consent
- information for patient and escort
3
Q
What social history is required for sedation assessment?
A
- nature of fear
- phobia v anxiety
- general to dentistry or specific (ie needle)
- occupation
- escort
- alcohol (inform no drinking on day of sedation)
- responsibilities
- transport
4
Q
What dental history is required for sedation assessment?
A
- referral source
- previous experience
- previous sedation or GA
- symptoms
- proposed procedure
5
Q
What medical history is required for sedation assessment?
A
- use PMH sheets
- go through answers with patient to ensure correct information and patient fully understood form
- ensure all drugs are known and check BNF for interactions
6
Q
What information is required for a drug history?
A
- any prescribed drugs need checked for interaction with sedative drugs
- any drug allergies
- recreational drugs
7
Q
Why is the drug history important?
A
Nearly all drugs increase the sedative effect of midazolam
8
Q
What are common drugs that increase the sedative effect of midazolam?
A
- alcohol
- opioids
- erythromycin
- antidepressants
- antihistamines
- antipsychotics
- recreational drugs
9
Q
What is a pharmacodynamic interaction?
A
- interaction between drugs that have similar or antagonistic effects
- predictable
10
Q
What is a pharmacokinetic interaction?
A
- one drug alters the absorption, distribution, metabolism or excretion of another therefore altering the effect of the drug
- unpredictable
11
Q
What drugs commonly cause pharmacodynamic effects with midazolam?
A
- antidepressants
- antihistamines
- both causes respiratory depression
12
Q
What vital signs are required as part of the sedation assessment?
A
- heart rate
- blood pressure
- oxygen saturation
- BMI
