Complications - bleeding Flashcards

1
Q

Coagulation defect?

A

e.g. warfarin, haemophilia, von Willebrands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vessel wall defect?

A

surgical trauma, lupus, scurvy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Platelet disorder?

A

thrombocytopenia, aspirin, clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of bleeding sockets?

A
    1. Clean the area
    1. PACK CORRECTLY
  • (Leave undisturbed for 15 mins. Sit patient up)
    1. Check history
  • (Predisposing pathology, family history, previous extractions, nature of surgery- timing etc.)
    1. Examine
  • (signs of underlying cause. Blood pressure and pulse - signs of shock)

In practice - LA, pack, suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Haemostatic agent?

A

surgicel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If packing and suturing in practice doesn’t work, what does the hospital do?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a prothrombin agent to promote clot formation?

A

Tranexamic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Local haemostatic agents?

A

Gauzepacks
* Sutures
* Vesselligation
* Diathermy
* Oxidisedcellulose(Surgicel)l

Bonewax
* Adrenaline/Epinephrine
* Astringents(Tannicacid,FeCl3, ZnCl2)
* Tranexamicmouthwash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Iatrogenic damage?

A

Broken instruments
- Burns
- Lacerations/abrasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dry socket aka?

A

localised alveolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is dry socket?

A

describes the empty appearance of a non- bleeding post-extraction socket due to loss of the blood clot.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What encouraged dry socket?

A

more extreme surgery encourages dry socket

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pt find dry socket more painful?

A

nerve endings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What to do with dry socket?

A

Clean

Albrogel

eugenol - calms nerves down

  • Reassurance
  • Radiograph - ? Retained root fragments/ foreign body
  • Debride & wash sterile saline / Chlorhexidine (may need regional block LA –avoid infiltrations)
  • Dress with resorbable obtundant antiseptic dressing eg Alvogyl (Iodoform/Eugenol/Butamben)
  • Analgesics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk factors for dry socket?

A
  • Smoking >20 cigarettes per day
  • Increased bone density (Pagets, osteoporosis)
  • Previous history of dry sockets
  • Oral contraceptive pill - more proteases and breakdown clot
  • Complex surgical procedures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why not LA next to dry socket?

A

adrenaline prevents new clot to form