special care and conscious sedation

Question 1

Give 4 examples of movement disorders

Answer 1

Any 4 from:
- muscular dystrophy
- cerebral palsy
- multiple sclerosis
- Parkinson’s disease
- Huntington’s Chorea
- Head injury

Question 2

What are the different types of learning difficulties?

Answer 2

Congenital - yndromic or non-syndromic
Acquired

Question 3

What are the 4 types of acquired learning difficulties?

Answer 3

Trauma
Infection
Cerebro vascular accident
Alzheimer’s

Question 4

What makes IS more difficult in patients with learning difficulties?

Answer 4

Patient must understand and be able to breathe through their nose with their mouth wide open

Question 5

What questions should be asked regarding sedation in patients with learning difficulties?

Answer 5

Will behavioural management be possible?
Is pharmacological management needed?
Is sedation needed, or GA, or both - based on patients understanding and pain experience

Question 6

Which act is used if you cannot get signed consent for sedation?

Answer 6

Adults with Incapacity (Scotland) Act 2000

Question 7

Give 2 advantages of oral/transmucosal sedation?

Answer 7

Any from:
- avoids cannulation
- can make induction more pleasant
- better cooperation
- better future behaviour

Question 8

Give 2 disadvantages of oral/transmucosal sedation

Answer 8

Any from:
- baseline readings
- bitter tasting/stinging
- lag time
- untitrateable
- difficulty in monitoring level of sedation
- behaviour in recovery