Behaviour Management Flashcards
Behaviour management techniques (8)
- Tell show do
- Positive reinforcement
- Role modelling
- Giving the child control eg hand signal
- Distraction
- Acclimatisation
- Voice control
- Desensitisation
Paracetamol doses mg (tablet?)
1-5 years: 125-250mg
5-12 years: 250-500mg
12-18 years: 500mg-1g
Paracetamol calpol doses and max dose amounts
120mg/5ml
250mg/5ml
Every 4-6 hours, max 4x a day
What is toxic paracetamol dose for adults per kg
150mg/kg
Ibuprofen indications and contraindications
Indications:
- pyrexia (fever)
- pain
- inflammation
Contraindications:
- asthma
- liver disease
- renal failure
- bleeding disorders
Ibuprofen doses per age and hourly regime
3-12months: 50mg
1-4 yrs: 100mg
4-7 yrs: 150mg
^^ max dose = 30mg/kg
7-10 yrs: 200mg
10-12 yrs: 300mg
12-18 yrs: 300-400mg
^^ max dose = 2.4g/kg (2400mg)
8 hourly - THEREFORE 3x max
Anaesthesia Vs analgesia definition
ANAESTHESIA:
- loss of all forms of sensation eg pain touch temperature pressure and or motor function
ANALGESIA:
- loss of pain sensation unaccompanied by loss of other forms of sensibility
Contraindications for lidocaine
- pts with past sensitivity to amide type analgesic agents
- severe liver disease
- allergy; v rare (to preservative)
What is the dosage of lidocaine and what is the max dose
2% lignocaine = 20mg/ml
2.2ml cartridge = 44mg
MAX DOSE
4.4mg/kg
Articaine dosage and max
Articaine 4%
88mg per cartridge
Max 5mg/kg
Adults = 7mg/kg
What are the different methods of LA administration
- topical
- infil
- blocks
- intrapapillary
- intraligamentary
Basic points for topical anaesthetic
- area of application must be dried
- should be applied over a limited area
- should be applied for sufficient time
- 15 seconds or so = useless
- only 2-3mm soft tissues depth
APPLICATION TIME: around 5 minutes recommended
IO topical LA uses (7)
- pre injection
- rubber dam clamp
- placing matrix band
- suture removal
- exfoliating primary teeth
- subgingival scaling
- incision of abscess
LA infiltration technique
- Dry mucosa
- Topical LA
- Wipe off excess topical
- Stretch mucosa
- Distract patient eg gentle pressure on lip
- Insert needle (ultra short 30 gauge or normal 30 gauge)
- Aspirate
- Inject supraperiosteal as close as possible to apices of teeth
Intra papillary injection technique
- avoids painful injection directly into palate
- after buccal infil, inject into interdental papilla mesial / distal to tooth
- pass needle horizontally through the papilla from buccal to lingual
LA intraligamental uses
- to supplement infiltrations
- May eliminate need for block
What is the excess dose of LA intraligamental + technique
0.2ml per root (0.2ml = width of bung)
- small buccal infil
- papillary injection
- intraligamental injection
- 30 degree angle to long axis of tooth in mesiobuccal gingival sulcus
- advance until resistance
ID block in kids technique and needle length
- identical technique to adults
- mandibular foramen is below occlusal plane thUS LOWER THAN IN ADULTS
- approach direct from primary molars of opposite side, lateral to pterygo mandibular raphe and medial to ascending ramus at SAME LEVEL of occlusal plane
- advance until touch bone, withdraw slightly, aspirate, deposit 1.5ml. Withdraw halfway, aspirate, deposit 0.5ml
LENGTH:
For kids 25mm needle satisfactory
For adults require 35mm (long needle)
Mental nerve block advs vs DISADVS
Advs;
- very good soft tissue anaesthesia
DISADVS;
- anaesthesia not as reliable as IDB
- incisors May get x-over supply across midline so need a buccal infil adjacent to tooth
Mental block technique
- advance needle in buccal sulcus toward region between apices of 1st and 2nd primary molars
Wand advs and DISADVS
Advs:
- computer controller dental injection flow rate
- injection slow and steady = comfortable
- looks less scary
DISADVS:
- more expensive
- takes time
- larger hazardous waste disposal and more costs to throw away
- takes up extra space
Complications of LA (8)
For patient:
- psychogenic (most common)
- lip biting/soft tissue trauma
- CARDIOVASCULAR - low levels = stimulant, but high levels = circulatory collapse
- CNS - depressant
- needle stick injury
- toxic (over dosage, low tolerance)
- allergic (rare)
- drug interaction (very rare)
