Chapter 20 Flashcards
Which patients are at risk for complications that can occur from extraction?
hemophiliac
patients taking anticoagulants
patients experiencing a hematoma
What is hemophilia
group of hereditary bleeding disorders with deficiency of clotting factor
can be mild to severe
True or False
Excessive bleeding patients require special care for extractions
True
What is the special care required for excessive bleeding?
recombinant factor injections or IV glues gelatin packing absorbable sutures vasoconstrictors in the local anesthetic compression for 3 days
What are the 3 categories of warfarin
low - no medication change
moderate - withdrawal 48 hours prior to extraction
high - consultation with physician - needs to determine risk of bleeding versus clotting
What is the international normalized ratio?
determines clotting time
used during warfarin therapy
2-3 target range
What is heparin?
used for thrombogenic episodes in hospitalized patients undergoing complicated surgery
reduces blood clotting immediately
short acting
no need to discontinue for simple procedures (ex: extraction)
What is aspirin?
used to treat ischemic heart disease, TIA, CVA
minor oral surgery acceptable on patients with low dose aspirin regimen
use of LA and compliance with follow-up procedures yields minimal post extraction bleeding
What is the treatment for hematoma?
apply firm pressure with gauze until no longer expanding, place cold pack, and possibly use antibiotics
if expansion continues - contact EMS
Signs and symptoms of excessive bleeding
heavy bleeding 2 + hours also look for: fever hypotension altered mental capacity hematoma
Post op instructions for excessive bleeding
no exercise 12-24 hours
lie down and elevate head for several hours
gauze over socket with pressure for 2 hours
Is oozing blood for 12 hours normal?
yes
Is steady flow of blood for 12 hours normal?
no
True or False
Tannic acid in tea bag provides clotting
True
The second most common problem in dental surgery is
?
