Wiley Chapter 10 Flashcards
What must be evaluated to determine if patient a good candidate for sedation?
child’s age, cognitive development, temperament, coping styles.
What form of anesthesia is close to being the magic bullet for sedation in children?
General Anesthesia
What age of children are usually not manageable in dental setting using behavioral techniques and need general anesthesia?
Usually under age 3
What is temperament and what three groups are there to describe a child’s temperament?
Temperament is typically how a child responds to novel environments and child’s basic daily expression.
1) easy-interactive and friendly
2) slow-to-warm up- do well but need some guidance
3)Difficult- withdrawn and disruptive behavior.
Generally, shy children express more distress and negative behaviors in dental settings
What drugs are contraindicated for tonsils greater than 50% in conscious sedation?
Chloral hydrate
How do you access tonsils in children in supine position?
Have them point chin up towards ceiling, open as wide as possible and say a soft “ahh.”
How to access tonsils in uncooperative child?
Knee to knee position, use mirror on tongue and slowly move back till gag reflex.. Must be quick to assess as they gag….only attempt once!
What vitals signs are the most important to listen too during sedation and why?
Respiratory breaths. First to be compromised is airway.
What does the oxy-hemoglobin dissociation curve tell us?
“S” shape curve. Desaturation occurs over a relatively drop in Pa02. Quick drop at 90% saturation so must monitor and make quick actions
In children, where should you place the pulse oximetry?
Toe next to big toe.
What does capnography measure and normal range?
Expired carbon dioxide. First line (beginning of rise in curve) includes dead space gases. 33-40mmHg
