IV sedation Flashcards
What is conscious sedation?
-Pt. retains an independent airway and can respond appropriately to commands
What is deep sedation?
-Depressed consciousness, partial loss of protective reflexes
What is general anesthesia?
-An induced state of unconsciousness with total loss of protective reflexes
What plane is conscious sedation?
-Plane 1
What is Plane 1 anesthesia?
-Amnesia stage
What is plane 2 anesthesia?
-Excitement or Delirium stage
What is plane III anesthesia?
-Surgical anesthesia stage
What is plane IV anesthesia?
-Medullary paralysis or danger stage
What is a medical indication for sedation?
- Mild systemic disease
- Spastic nerve/muscle disorders
- Mild mental/psychiatric disorders
What is a dental indication for sedation?
- Persistent fainting
- Moderately difficult surgery
- Gagging
- Trismus
- Idiosyncratic reaction to LA
What are Medical contra-indications for sedation?
- Severe systemic disease (ASA III)
- COPD (except asthma)
- Pregnancy
- Myasthenia gravis
- Medication such as anti-psychotics
- Severe psychiatric Disorder
- Obesity/bleeding dyscrasia’s
What are socio-psychological contraindications for sedation?
- Uncooperative
- Unwilling
- Unaccompanied patients
What is a dental contraindication for sedation?
- Prolonged difficult surgery
- Insufficient personnel
- Insufficient resources
What are requirements for ideal sedation?
- Safety
- Simplicity
- Optimal action
- Analgesia
- Amnesia
- Acceptability
- Compatibility
- Cost
What are drugs that you can give sublingually or and endotracheal tube?
- Narcan
- Atropine
- Valium
- Epinephrine
- Lidocaine
What route if IV sedation?
-Parenteral
What is an advantage of IV sedation?
- Direct to blood 22-122 seconds for hypnotic
- Rapid onset of action
- Can titrate effect rapidly
- Control duration of sedation
- Have access for emergent therapy
If you do IV sedation how many people have to be in the room with you?
-2-3 personnel
How long before surgery should a person not eat food or fluid prior to surgery?
-6 hours
Clear fluid intake should not be taken within how soon of surgery?
-2 hours
Why should you use a capnography?
Because it can identify apnea or airway compromise much earlier than pulse oximetry
When is a temperature recording mandated?
-Only during deep sedation
What does a pulse oximeter measure?
- Arterial oxygen saturation of hemoglobin
- ratio of oxygenated Hb and total Hb
All types of IV sedation should have what monitoring?
- Blood pressure monitoring
- Pulse oximeter
- ECG
- Pre-coridal stethoscope
- Capnography
- Temperature recording
- Time based record at least 5 minutes apart
What can be sources of error for pulse oximetry readings?
- Body movements
- Dyshemoglobeinemias
- Lipids and bilirubin
- Color interferences: nail polish
- Venous pulsations
- Physical factors
What does Capnography measure?
-The amount of carbon dioxide in the expired gases
T/F It is now mandated that anyone who does IV sedation whether conscious, deep, or general has to have a capnography.
True
T/F Increases in end tidal CO2 measured through a capnograph precede the decrease in oxygen saturation measured by pulse oximetry.
True
What is the alarm low limit for systolic BP?
-85
What is the alarm high limit for systolic BP?
-150
What is the alarm low limit for diastolic BP?
-50
What is the alarm high limit for diastolic BP?
-100
What is the alarm low limit for HR?
-50
What is the alarm high limit for HR?
-110
What is the alarm low limit for O2?
-92
What is the alarm high limit for O2?
-100
