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sedation midterm > sedation midterm 2 > Flashcards

sedation midterm 2 Flashcards

1
Q

Above which BP number do you not do elective dentistry on? ​

A

165/95

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2
Q

What are the 2016 ADA revisions? ​

​

A

1) Mandate Capnography (expired CO2) for moderate sedation to general anesthesia but NOT FOR MINIMAL​
2) States BMI and sleep apnea should be screened for BEFORE sedation (Yes minimal) ​

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3
Q

What is the best functional test for ASA? ​

A

Walking up a flight of stairs

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4
Q

What is the best instrument for ASA determination? ​

A

Spirometer too look at oxygen consumption. The more oxygen you can burn, the better your cardiovascular health

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5
Q

What is safer than general anesthesia that is gaining more use these days?​
Why? ​

A

Sedation with local anesthesia ​

General anesthesia is taxing on the body and you can lose patients just by that process itself. Now days, LA + sedation is preferred for those patients due to decreased mortality ​

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6
Q

What is an ASA 6 patient? ​

A

HEALTHY people that might have some brain injury – now they’re donors

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7
Q

In what group of patients is a LOW BMI dangerous? ​

A

OLD people and little kids failing to thrive ​

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8
Q

People with capacities of _____ METS or less are at high risk for medical complications

A

4

*10 METS or more is very low risk

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9
Q

f someone has been fighting high blood pressure their whole life, and then suddenly, we see a decrease, do we celebrate?

A

Nah, they’ve probably got Heart Failure. Things are bleak fam​

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10
Q

What does sedation do to BP? ​

A

sedation lowers BP

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11
Q

another name for valium?

moderate dose?

A

diazepam (which lowers BP)

  • generic name
  • moderate dose of 10mg
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12
Q

Does lidocaine, in high doses, sedate the brain? ​

A

yes

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13
Q

What is the gas in australian? ​

A

Methoxoyflurane

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14
Q

Before you get a patient to do drugs, what do you need first? ​

A

1) informed consent not while under influence

2) signed consent

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15
Q

What is the ONE drug you don’t need a designated driver for? ​
​

A

Nitrous oxide (N2O)

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16
Q

1) What is the best route of drug administration?​

2) Second best?

A

1) IV

2) gas inhilation

17
Q

What hair color is harder to sedate? ​

A

Midazolam appears to cause significant less sedation and cognitive imparement in red haired subjects​

18
Q

How does ethyl alcohol absorption get affected by food vs no food?

A

Think about that one time you slammed 4 white class with no food vs when you do pizza and beer, and kill the whole 6 pack

19
Q

Why should states consider dropping the permit for sedation? ​

A

RISK of sedating a patient with nitrous oxide/oxygen alone is LESS than not sedating the same person ​

20
Q

What is the fentanyl patch? Can it kill you? ​ What increases the absorption rate?

A

opiod patch for pain

  • Yeah, ROA has no administration on concentration. Fenty causes resp depression ​
  • heat speeds it up
21
Q

What do sedation agents hit first – what aspect of the patient? how to assess?

A

Their CNS ​

*** A patient should be able to talk and respond when commanded ​if conscious

22
Q

name 3 sedation scales

A

1) University of Michigan ​
Sedation Scale (UMSS) ​
* 0 is awake, 4 unarousable

2) Responsiveness Scores of the Modified Observer’s Assessment of Alertness/Sedation Scale (OAA/S)​
* 0 no response, 5 responds readily *subjective

3) Bispectral analysis (BIS)
* OBJECTIVE * determines the patient’s sedation based on EEG *N2O doesn’t register

23
Q

What is OAA/S?

A

This is a responsiveness scale of a patient post sedation. It’s not perfect and is subjective !

Responsiveness Scores of the Modified Observer’s Assessment of Alertness/Sedation Scale (OAA/S)​
* 0 no response, 5 responds readily

24
Q

Bispectral analysis (BIS) vales for: Light to moderate sedation, Deep sedation​, General anesthesia​ and Hypnotic state

A

Light to moderate sedation 70-90​

Deep sedation​ 60-70

General anesthesia​ 40-60

Hypnotic state 40-lower

25
Q

BIS does not work with

A

N2O

26
Q

Nitrous Oxide vs
Nitric Oxide vs
NO2

A

Know that Nitrous Oxide – is N2O​

Know that Nitric Oxide is NO​

Know that NO2 – Nitrogen Dioxide

27
Q

What does Pulse Oximetry measure?​

A

Non-invasively measures the percent oxygenation of hemoglobin in capillary blood and Heart Rate (know on exam)

28
Q

What number that your pulse ox should be above? ​

A

Should be above 90​

  • Most common pulse oximetry is 98% saturated.
  • People that have bad lungs come in at 91 or 92% ​
29
Q

If you give soemone nitrous oxide, do they have MORE or LESS oxygen saturation compared to room air? ​

A

They have MORE saturation compared to room air, since you give them like 30% where as room are is 18-20%

30
Q

Why do we like Capnography?

A

CO2 is FASTER at detecting if people aren’t breathing. So you won’t actually that as quickly reflected in your pulse ox. Why? Well when you stop breathing, you stop exhaling, your capnogrpahy will immediately register that. Compared to a pulse ox- blood takes some time to desaturate

31
Q

Explain the wave peaks with capnogrpahy​

​

A

Wave form - when you exhale, there is a positive wave form (your CO2 and expired air can be measured with capnography)

  • when you inhale, there is a negative wave form
32
Q

If you are doing moderate to deep sedation, what do you need to do per the ADA? ​

What disease and emergency procedure can you check with this?

A

CO2 (capnography) and O2​

*check for the asthma and if intubation tube when into trachea (NOT esophagus)

33
Q

What test should a patient do before they leave from nitrous?

A

TRIEGER TEST to document recovery from nitrous

34
Q

What do you need on your crash cart if you’re doing sedation?

A

BLS is important for everyone ​

Reversal drugs ​

Oxygen​

AED

35
Q

How much oxygen is given with mouth to mouth? ​
** What is better and what percentage? ​

​

A

Mouth to mouth is 16-17% ​

** The bag is almost 100%

36
Q

What is AED great for? ​

What state do you need an AED in your office?​

What is more important in your office than an AED? ​

A

HEART ATTACK
*needed in Flo-rida

breathing devices are more important because you will cause respiratory depression

sedation midterm (4 decks)

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