Pre sedation assessment Flashcards
What is the aim of a pre sedation assessment
If the patient is suitable for sedation and what the course of treatment will be
Where do we carry out the pre sedation assessments
Aim to carry out in an area away from the dental surgery
What do we aim to find out in a pre sedation assessment
- Reason for sedation
- Expectation of sedation
- Fitness for sedation
- Likely suitability
- social circumstances
- What causes their anxiety
What are the different components of a pre sedation assessment
- Medical assessment
- Social assessment
- Dental assessment
What does the medical assessment for a pre sedation assessment include
- Questionnaire
- General examination
- Pulse, blood pressure, O2 saturation
- BMI
Is a dental assessment always possible during the pre sedation assessment
Not always but we can try to take extra oral radiographs
What is the cut off for sedation at the LDI
Will not sedate any outpatient with a BMI over 35
After assessing a patient medical and social history what do we aim to come to
An ASA classification score
What does the ASA classification stand for
American society for anaesthesiology
How is an ASA classification score presented
As a number 1-6
What does a 1 on the ASA classification scale represent
A normal healthy patient
What does a 2 on the ASA classification scale represent
A patient with mild systemic disease eg well controlled diabetes/epilepsy, mild asthma
What does a 3 on the ASA classification scale represent
A patient with severe systemic disease
What does a 4 on the ASA classification scale represent
A patient with severe systemic disease that is a constant threat to life (unstable angina)
What does a 5 on the ASA classification scale represent
A moribund patient not expected to survive without the operation
What does a 6 on the ASA classification scale represent
A declared brain dead patient who’s organs are being removed for donor purposes
What is the ASA of a current smoker, social drinker or patient with bMI of 30-40
ASA ranking of 2
What do we look t when assessing a patients social hisogtry
- Insight into patients current work situation
- Home circumstances and caring responsibilities
- Does patient have an appropriate escort for at least 24 hours post op
What do we decide following a pre sedation assessment
- Whether sedation is indicated
- What medical or other problems have to be overcome and how
- Which treatment to be performed at which visit eg quadrant dentistry
What do we need to advise the patient about following a pre sedation assessment
- Effects of sedation
- Sedation is not GA
- Nature and duration of the effects of sedation
- Techniques and equipment
- Need for escort and transport
- Feeding and medication
- No alcohol for at least 24 hours
- Avoid social media and online shopping as they may forget what they have done
- Have a light meal beforehand
How long do the effects of sedation linger
Around 24 hours
What do we let the patient do during a pre sedation assessment
- Ask any questions
- Meet the staff
- See the room
- see equipment that thy think might frighten them if they wish
- Sign the consent document
What do we need to give in written form to the patient during the pre sedation assessment
- Pre op instruction
- Post op instructions
- Appointment if Indicated
What do we check on the day of the sedation appt
Check for:
1. Health changes
2. Escort and transport
3. Preparation eg no alcohol or recreational drugs for 24 hrs prior
4. Consent
