Pediatric sedation Flashcards
What is Frankl 1?
-Definitively negative - refuses treatment
What is Frankl 2?
-Negative reluctant but slightly cooperative somewhat withdrawn
What is Frankl 3?
-Positive cautions but willing to comply
What is Frankl 4?
-Definitively positive enjoys being at the dentist
What are the four goals in pediatric sedation?
- Make the child cooperative and comfortable
- Decrease anxiety for the patient
- Decrease strain, apprehension, and excessive fatigue for the dentist and staff
- Minimize the need for hospitalization
What are 5 techniques used for pediatric sedation?
- Inhalation sedation
- Oral sedation and inhalation sedation
- Oral sedation
- In office general anesthesia
- General anesthesia in hospital
What can you use for oral sedation in a pediatric pt?
-Hydroxyzine
What is the age to be considered a geriatric patient?
-Age 65
What is the most significant age related postoperative complication of sedation and general anesthesia?
-Delirium
What anatomic changes in body composition occur in a geriatric pt?
- Increased lipid fraction
- Loss of skeletal muscle and other components of lean body mass
What anatomic changes in nervous systems occur in a geriatric pt?
- Attrition of neurons
- Decreased neurotransmitter activity
What anatomic changes in the cardiovascular systems occur in a geriatric pt?
- Decreased arterial elasticity
- Ventricular hypertrophy
- Reduced adrenergic responsiveness
what anatomic changes in the pulmonary system occurs in a geriatric pt?
- Loss of lung elastin
- Increased thoracic stiffness
- Reduced alveolar surface area
What anatomic changes in the renal system occur in geriatric pts?
- Reduced vascularity
- Tissue atrophy
What anatomic changes in the hepatic system occurs in geriatric pts?
-Reduced tissue mass
What functional changes in the body composition occurs in geriatric pts?
- Increased half life for lipid soluble drugs
- Decreased O2 consumption, heat production and cardiac output
What functional changes in the nervous system occur in the geriatric pt?
- Deafferentation, neurogenic atrophy and decreased anesthetic requirement
- Impaired autonomic homeostasis
What function changes in the cardiovascular system occur in the geriatric pt?
- Increased impedance to ejection, widened pulse pressure
- Decreased maximum cardiac output
What functional changes in the pulmonary system occurs in the geriatric pt?
- Increased residual volume
- Loss of vital capacity
- Impaired efficiency of gas exchange
- Increased work of breathing
What functional changes in the renal system occurs in the geriatric pt?
-Decreased plasma flow, glomerular filtration rate, drug clearance, and ability to handle salt and water loads
What functional changes in the hepatic system occurs in the geriatric pt?
-Reduced hepatic blood flow and drug clearance
