5 GA for children

Question 1

how does inhaled GA work?

Answer 1

enter lungs, distributed to tissues by circulation, reach specific sites in CNS by crossing blood brain barrier, magnitude proportional to partial pressure

Question 2

how does iv GA work?

Answer 2

given straight into circulation, distributed through body and reach specific sites in CNS by crossing blood brain barrier

Question 3

give examples of inhaled agents

Answer 3

nitrous oxide, sevoflurane, halothane, isoflurane, desflurane

Question 4

give examples of iv agents

Answer 4

propofol

Question 5

what are the types of airway?

Answer 5

laryngeal mask airway
nasal endotracheal intubation
oral endotracheal intubation

Question 6

what is a throat pack?

Answer 6

guaze to pack around tube back of mouth to catch saliva, blood, water etc. entering airway

Question 7

what are the stages of anaesthesia?

Answer 7

1. induction
2. excitement
3. surgical anaesthesia
4. respiratory paralysis/overdose

Question 8

what are the indications for GA?

Answer 8

too young
too anxious
too uncooperative to recieve tx any other way
dentist need px to be completely still as operation is complex

Question 9

what are the major risks of GA?

Answer 9

serious outcome/major adverse event 3 in a million
death
brain damage
not wake up

Question 10

what are the minor risks of GA?

Answer 10

pain
malignant hyperpyrexia
laryngospasm
prolonged aprnoea
paralysed but not asleep
headache
nausea/vomiting
sore throat
sore nose/nose bleed
drowsiness
upset
anxiety about future dental tx
risks from tx

Question 11

who surgical safety checklist

Answer 11

brief before
debrief after
for every px:
sign in
time out
sign out

Question 12

discharge criteria

Answer 12

fully conscious- able to maintain airway, reflexes
satisfactory oxygenation and respiration
cvs stable
pain, nausea, vomiting controlled
temp normal
eaten, drank, been to toilet

Question 13

post-op instructions

Answer 13

pain control
travel home
rest - no school next day
monitoring
what to look out for- eg bleeding
extraction advice
soft diet
prevention
follow up
discharge letter

Question 14

how is consent achieved

Answer 14

active
primary only refer
explanation of risks & benefits of GA and alternatives
1st app only consult

Question 15

what should a referral letter state?

Answer 15

px name
px address
px contact number
medical history
GP details
parental responsibility
justification for GA 
proposed tx plan
previous tx details
recent radiographs