GA Consent

Question 1

What are the two indications for use of GA in children?

Answer 1

-The child needs to be fully anaesthetised before dental treatment procedures can be attempted
-The surgeon needs the child fully anaesthetised before treatment can be performed.

Question 2

What needs to be considered when discussing GA with a child and carer?

Answer 2

-The cooperative ability of the child
-The perceived anxiety and how the child has responded to similar procedures
-The degree of surgical trauma anticipated
-The complexity of the operative procedure
-The medical status of the child.

Question 3

What are circumstances and conditions suitable for GA?

Answer 3

-Severe pulpitis requiring immediate relief
-Acute soft tissue swelling requiring removal of the infected tooth
-Surgical draining of an acute infected swelling
-Single or multiple extractions in a young child unsuitable for conscious sedation
-Symptomatic teeth in more than one quadrant
-Moderately traumatic or complex extractions
-Teeth requiring surgical removal or exposure
-Biopsy of a hard or soft tissue lesion
-Debridement and suturing of orofacial wounds
-Established allergy to LA
-Post operative haemorrhage requiring packing and suturing
-Exam under GA for a special needs child.

Question 4

What circumstances and conditions rarely justify GA?

Answer 4

-Carious, asymptomatic teeth with no clinical or radiographic signs of sepsis
-Orthodontic extraction of sound permanent premolar teeth in a healthy child
-Patient/carer preference, except where other techniques have already been tried.

Question 5

What following monitoring devices must always be available to ensure the safe conduct of GA?

Answer 5

-Pulse oximeter
-Non-invasive blood pressure monitor
-ECG
Airway gas monitor
-Airway pressure monitor.

Question 6

What is first stage, second stage and late recovery?

Answer 6

1. The stage lasts until the patient is awake and protective reflexes have returned, pain is controlled.
2. This stage begins at the end of stage 1 and ends when the patient is ready to be discharged from the hospital.
3. This phase is very variable and ends when the patient has made a full physiological and psychological recovery from the surgical procedure.

Question 7

What should post-op instructions include?

Answer 7

Analgesia
Post-op nausea and vomiting
Residual effects of GA
Bleeding
Mouth-care
Details of any sutures in-situ
Eating
Return to school or normal activities
Lines of communication in the event of post-operative problems
Prevention of caries.

Question 8

How long does consent for last when gained for GA?

Answer 8

3 months.