5. Bleeding risk + haemorrage in OS patients

Question 1

Answer 1

Question 2

What is haemorrhage?
What are the types of haemorrhage and when can they occur?

Answer 2

Haemorrhage = blood lost from a ruptured vessel

Question 3

Haemostasis
What is haemostasis?
What are the types of haemostasis?
What are the stages of haemostasis?

Answer 3

Question 4

What is coagulation?
What does coagulation occur through?

Answer 4

Question 5

What is the coagulation cascade?
What are the different pathways?

Answer 5

Question 6

Why is fibrinolysis

Answer 6

Question 7

How is haemostasis controlled?

Answer 7

Question 8

What happens if promotors of local haemostasis are overactive?
What happens if prevention of generalised thrombosis are overactive?

Answer 8

Question 9

What are the causes of excessive over bleeding?

Answer 9

Abnormalities in blood vessels, platelets or coagulation

Question 10

Blood vessel abnormalities
What are examples of inherited blood vessel abnormalities?
What are examples of acquired blood vessel abnormalities?

Answer 10

Question 11

Question 12

What is thrombocytopenia?

Answer 12

Thrombocytopenia = decrease in number of platelet count

Question 13

What is the normal range of platelets?

Answer 13

Normal range = 150-400x 10^9/l

Question 14

What is the minimum number of platelets needed for dental extraction?

Answer 14

50 x 10^9 / l

Question 15

What is the minimum number of platelets needed for LA infiltration

Answer 15

30 x 10^9 / l

Question 16

Abnormal platelets / platelet defects
What are examples of inherited platelet defects?
What are examples of acquired platelet defects?

Answer 16

Question 17

Antiplatelet therapy
How does it work?
What is it used for?
Action?

Answer 17

Question 18

Antiplatelet therapy
What is traditional Antiplatelet therapy and examples?

Answer 18

Question 19

Antiplatelet therapy
What is new Antiplatelet therapy and examples?

Answer 19

Question 20

Antiplatelet therapy
What is dual antiplatelet therapy?
What are other drugs that can affect platelets?

Answer 20

Question 21

Can an Extraction be done with antiplatelet drugs ?

Answer 21

Question 22

What is Coagulopathy

Answer 22

Coagulopathy - Clotting of the blood is impaired = bleeding

Question 23

Coagulation Disorders
Examples of inherited coagulation disorders?
Examples of acquired coagulation disorders?

Answer 23

Question 24

What are the different anti coagulants dentists encounter

Answer 24

Warfarin
DOACS
Heparin/Clexane (injectable)

Question 25

Warfarin Action? Onset? Monitoring? Reversible? Interactions? Use?

Answer 25

Question 26

DOACS Action? Onset? Monitoring? Reversible? Interactions? Use?

Answer 26

Question 27

Heparin/Clexane Action? Onset? Monitoring? Reversible? Interactions? Use?

Answer 27

Question 28

What are examples of DOAC drugs?

Answer 28

Dabigatran RivaroXaban ApiXaban EdoXaban

Question 29

How do DOAC drugs affect the coagulation cascade?

Answer 29

Question 30

Extraction on DOACs Can Extraction be done on warfarin?

Answer 30

Question 31

Extraction on DOACs What are the rules for extractions for other common doacs?

Answer 31

Question 32

Extraction on DOACs Extraction when taking combination anticoagulants?

Answer 32

Question 33

How can we assess risk or likelihood of a patient bleeding following oral surgery intervention

Answer 33

Question 34

What do you do for extraction in a low risk patient for bleeding? What do you do for extraction in a high risk patient for bleeding?

Answer 34

Question 35

Management of a bleeding patient? Is it different for the different types of bleeding?

Answer 35

Question 36

Management of a bleeding patient using local haemostatic measures is as follows:

Answer 36

Question 37

What are the practical steps on achieving haemostatic control?

Answer 37

DIAGRAM 3 EXTRA - ensure gauze pack is moist using saline to prevent blood clot being pulled out when gauze pack is removed - soaking packet in tranexamic acid solution can help to further promote haemostasis

Question 38

What is tranexamic acid?

Answer 38

Question 39

What is tranexamic acid used for?

Answer 39

Question 40

What happens if attempt to stop bleeding are: Successful? Unsuccessful ?

Answer 40

Question 41

What does management of all medically complex patients involves :

Answer 41