Emergency Drug Kits: Pharmacological and Technical Considerations

Abstract The risk for complications while providing dental procedures is greatest when caring for patients having significant medical compromise. It is comforting that significant adverse events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, the office team must be prepared to manage untoward events should they arise. This continuing education article will address basic emergency drugs that should be available in all dental practices and additional agents that become essential for those practices providing various levels of procedural sedation or general anesthesia.

Download Full-text

Recognition and Management of Complications During Moderate and Deep Sedation Part 1: Respiratory Considerations

Anesthesia Progress ◽

10.2344/0003-3006-58.2.82 ◽

2011 ◽

Vol 58 (2) ◽

pp. 82-92 ◽

Cited By ~ 7

Author(s):

Daniel E. Becker ◽

Daniel A. Haas

Keyword(s):

Continuing Education ◽

General Anesthesia ◽

Intraoperative Monitoring ◽

Deep Sedation ◽

Preoperative Assessment ◽

Management Of Complications

Abstract The risk for complications while providing any level of sedation or general anesthesia is greatest when caring for patients having significant medical compromise. It is reassuring that significant untoward events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, we must be prepared to manage untoward events should they arise. This continuing education article will review respiratory considerations and will be followed by a subsequent article addressing cardiovascular considerations.

Download Full-text

Recognition and Management of Complications During Moderate and Deep Sedation. Part 2: Cardiovascular Considerations

Anesthesia Progress ◽

10.2344/0003-3006-58.3.126 ◽

2011 ◽

Vol 58 (3) ◽

pp. 126-138 ◽

Cited By ~ 2

Author(s):

Daniel E Becker ◽

Daniel A Haas

Keyword(s):

Continuing Education ◽

General Anesthesia ◽

Intraoperative Monitoring ◽

Deep Sedation ◽

Preoperative Assessment ◽

Cardiovascular Complications ◽

Management Of Complications

Abstract The risk for cardiovascular complications while providing any level of sedation or general anesthesia is greatest when caring for patients already medically compromised. It is reassuring that significant untoward events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, providers must be prepared to manage untoward events should they arise. This continuing education article will review cardiovascular complications and address their appropriate management.

Download Full-text

The Sedation Continuum

The Pediatric Procedural Sedation Handbook ◽

10.1093/med/9780190659110.003.0003 ◽

2018 ◽

pp. 20-25

Author(s):

Élise W. van der Jagt

Keyword(s):

Adverse Events ◽

General Anesthesia ◽

Deep Sedation ◽

Procedural Sedation ◽

Dynamic Nature ◽

Moderate Sedation ◽

Patient Will ◽

Physiologic Responses

When patients undergo procedural sedation/analgesia, they enter into a sedation continuum. Several levels have been formally defined along this continuum: minimal sedation/anxiolysis, moderate sedation, deep sedation, and at the deepest level, general anesthesia. An additional and somewhat separate level in the sedation continuum is dissociative sedation, which has its own unique characteristics. Given the dynamic nature of the sedation process, a patient will move in and out of these defined levels (as well as intermediate ones) depending on the agents and dosing used, the procedures being performed, and a patient’s own unique characteristics and physiologic responses. At all times, the provider of procedural sedation/analgesia must be able to recognize the sedation levels attained by the patient and be ready to manage any potential adverse events.

Download Full-text

Covid-19 and its financial effects on the dental fraternity and health-care workers: A literature review

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.2883 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 628-631

Author(s):

Devangi Agrawal ◽

Namisha Khara ◽

Bhushan Mundada ◽

Nitin Bhola ◽

Rajiv Borle

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Workers ◽

Care Providers ◽

Dental Procedures ◽

Care Workers ◽

Dental Practices ◽

Precautionary Measures ◽

The Government ◽

Set Up

In the wake of the current outbreak of novel Covid-19, which is now declared as a 'pandemic' by the WHO, people around the globe have been dealing with a lot of difficulties. This virus had come into light in December 2019 and since then has only grown exponentially. Amongst the most affected are the ones who have been working extremely hard to eradicate it, which includes the hospitals, dental fraternity and the health-care workers. These people are financially burdened due to limited practise. In the case of dentistry, to avoid the spread of the virus, only emergency treatments are being approved, and the rest of the standard procedures have been put on hold. In some cases, as the number of covid cases is rising, many countries are even trying to eliminate the emergency dental procedures to divert the finances towards the treatment of covid suffering patients. What we need to realise is that this is probably not the last time that we are facing such a situation. Instead of going down, we should set up guidelines with appropriate precautionary measures together with the use of standardised PPEs. The government should also establish specific policies to support dental practices and other health-care providers. Together, we can fight this pandemic and come out stronger.

Download Full-text

Risk Factors for Adverse Events in Emergency Department Procedural Sedation for Children

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2017.11.006 ◽

2018 ◽

Vol 54 (1) ◽

pp. 139-140

Author(s):

Davida Hemmy

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Adverse Events ◽

Procedural Sedation

Download Full-text

Does the sedation regimen affect adverse events during procedural sedation and analgesia in injection drug users?

CJEM ◽

10.2310/8000.2013.130933 ◽

2013 ◽

Vol 15 (05) ◽

pp. 279-288 ◽

Cited By ~ 2

Author(s):

Frank Xavier Scheuermeyer ◽

Gary Andolfatto ◽

Hong Qian ◽

Eric Grafstein

Keyword(s):

Adverse Events ◽

Injection Drug Users ◽

Drug Users ◽

Vital Signs ◽

Injection Drug ◽

Procedural Sedation ◽

Secondary Outcome ◽

Procedural Sedation And Analgesia ◽

Pearson Coefficient ◽

Sedation And Analgesia

ABSTRACT Objectives: Injection drug users (IDUs) often undergo procedural sedation and analgesia (PSA) as part of emergency department (ED) treatment. We compared adverse events (AEs) using a variety of sedation regimens. Methods: This was a retrospective analysis of a PSA safety audit in two urban EDs. Consecutive self-reported IDUs were identified, and structured data describing comorbidities, vital signs, sedation regimens (propofol [P], propofol-fentanyl [PF], fentanyl-midazolam [FM], ketofol [1:1 ketamine:propofol, KF], and ketamine-propofol [KP]) and AEs were collected. The primary outcome was the proportion of patients in each sedation group having an AE; the secondary outcome was the proportion of patients having a cardiovascular or respiratory AE. Results: Data were collected on 276 IDUs (78 P, 82 PF, 65 FM, 25 KF, and 26 KP), and 18 patients had AEs (6.5%, 95% CI 4.0–10.3). The AE rates were 0.0%, 8.5%, 9.2%, 12.0%, and 7.6%, respectively, with propofol having a significantly lower rate (Pearson coefficient 14.9, p = 0.007). The cardiovascular/respiratory AE rates were significantly different as well, with P, KP, and KF having the lowest rates (Pearson coefficient 13.3, p = 0.01). Conclusions: For IDU PSA, the overall AE rate was 6.5%, and propofol appeared to have a significantly lower rate.

Download Full-text