Pharmalogical Managment Flashcards
What approach should be taken in the treatment under the GA?
Radical treatment, in doubt go for the radical treatment so the patient would not have to undergo GA again
Why preventive appointments should be done after GA treatment ?
To make positive impact on the patient
What is the main difference between the GA and sedation?
In GA there is loss of the protective reflexes so the patient can’t cough or breath in his own for example
How to prevent the aspiration of debris during GA ?
Using throat packs
What is the objective of the GA ?
To eliminate motor and sensory activity to facilitate delivery of comprehensive dental treatment
T/F A patient during the GA can’t breath by his own and needs assistance to maintain open airway and ventilation is needed
True
Mention the 3 groups of conditions that GA anesthesia is performed
1/ out patient short case by nasal mask
2/ out patient day-stay intubation anesthesia ( in the dental clinic)
3/ in patient hospital- stay intubation anesthesia
What are the indications for GA
1/ patients that need extensive dental care
2/ patients that can not cooperate
3/ patients with general medical problems
T/F For patients with LA allergy is the sedation is an option ?
False , the sedation needs LA as well so the GA is the only option
T/F patients under the age of 3 can be treated with GA
True
What are the contraindications of the GA
1/ respiratory infection
2/ active systemic disease with elevated temperature
3/ a healthy cooperative patient with minimal dental needs.
What are the advantages of the GA
1/ safe and efficient to treat the patients that can’t be treated in dental chair
2/ child doesn’t need to cooperate
3/allows for extensive treatment to be done in one visit
4/ the use of the throat packs to prevent the aspiration of debris
5/ doesn’t cause emotional trauma on the pt
What are the disadvantages of the GA
1/complications are the higher compered to the conscious sedation.
2/Needs a trained team and a special equipment and facilities.
3/Needs lab tests and chest x ray before the GA
4/ The patient can not eat before 6 hrs of the GA
5/ it is expensive
Why the GA has higher complications?
Because it depresses the Cv system and respiratory system and contraindicated for some medical compromised pts like cystic fibrosis patients
Why the dentist may find a problem while treating a pt under GA?
1/Because the breathing tube pushes the tongue forward making it in the way
2/ the muscles are paralyzed and the dentist is dealing with a dead weight and the pt can not move so the dentist has to move
3/ it’s physically demanding and many procedures are done in one session
What should be done on the patient before the GA procedure?
1/ at least 2 topical fluoride.
2/ dietary consultation regarding nursing/bottle feeding
3/assessment of the oral hygiene
Why the oral hygiene should be assessed before the GA
Because the bad oral hygiene and bottle feeding cause the failure of the treatment
What are the steps of dental treatment under the GA
1/ treatment of the main complain like the pain and sepsis
2/ application of topical fluoride
3/ comprehensive dental treatment
What should be done post operatively
After 3 months an appointment for complain assessment and topical fluoride application
- what are the drugs used for GA
Nitrous oxide
Halothane
(Flu-rane Family) enflurane , isoflurane , desflurane , sevoflurane
Who are the team members during GA procedure
Dental assistant Dental nurse Anesthesiologist Recovery nurse Dentist
What are the eliminates of monitoring
Continues and close observation especially oxygenation , ventilation and circulation.
Pulse oximetry
Chest breathing and skin color
Capnography
What are the causes of complications
Very young age
Non-hospital facilities
Absence of well trained observers
Errors in calculation of the drugs uses
What are the complications of the GA
Main : death
Minor : hypoxia , vomiting, hypothermia and prolonged recovery time
Other complications?
Cv and respiratory dysfunction
Laryngeal edema
Injury to body parts
Malignant hyperthermia
Which one is the complication of GA
hypothermia or hyperthermia?
Both !
What may cause the prolonged recovery and sliding to deeper sedation phase or cardiopulmonary depression
The pate absorption of the drugs
What equipment should be present for rescue before procedure?
SOAP ME 🧼
Suction, oxygen, airways open , pharmacy, monitors and equipment
What the precautions in the aftercare
Recovery position
Discharge policy
Emergency contact
What is the recovery position
On the side
What is example of discharge policy
Pt walking by his own after the recovery
Adult accompany the pt after recovery
