| Post-Treatment Phase has the potential for? |
The potential for hypoxia is realted to the age of the patient, the
duration of the sedation procedure, and the oxygen saturation. |
| What has a strong correlation to diffusion hypoxia? |
The occurrence of headaches,nausea, and lethargy after a nitrous oxide
inhalation conscious sedation procedure. |
| What is local anesthesia? |
total blocking the neural pathway to the brain. |
| What are the basic pharmacology facts? |
Nitrous oxide diffuses readily to and from the blood and body tissues.
It doesnot change it's form in this process.
The majority of the
gas is exhaled from the body within 3-5 minutes after termination |
| Oxygen is stored in the cylinder as a ? |
Gas |
| What is Anesthesia? |
Anesthesia may be accomplished by putting the brain itself to sleep as
in GENERAL ANESTHESIA or by totally blocking the neural pathway to the
brain as in local anesthesia. |
| What is the purpose of the reservoir bag? |
The purpose is to even gas flow during various respiratory demands
which prevents wide swings in gas concentrations. |
| What will laryngospasm prevent? |
this spasm will prevent air flow in the conducting airway which is
obviously an emergent problem. |
| What is the Central Storage System? |
Larger gas cylinders(G or H cylinders) are stored in a dedicated are
away from the operatory. The cylinders are connected to the opt by copper
tubing. The machine is connected to the wall outlet for a gas supply in
each opt. This machine may be fixed to the wall or in a cabinet of the
opt. The major ADVANTAGE of this system is the continued cost efficiency
of gas purchase. The DISADVANTAGE is the initial cost of the machine. |
| What is a laryngospasm? |
It is when you are in a deeply sedated or excitable state, the
laryngeal muscles controlling vocal cord movement may spasm. |
| What is the function of the epiglottis? |
It acts as a valve over the conductive airway by closing during
swallowing. It prevents food, liquid or foreign objects from entering the
airway. |
| What does general anesthesia? |
when the brain puts itself to sleep. |
| What type of condition is diffusion hypoxia? |
It is a condition that occurs at the termination of the nitrous oxide
inhalation conscious sedation procedure. |
| Oxygen and nitrous are not flammable but will support? |
Combustion |
| Explain the pressure-volume effect? |
Nitrous oxide has a much faster diffusion ratio than nitrogen. This
fact is significant in closed air spaced such as the middle ear. The
difference is referred to as the pressure-volume effect |
| What do you do if hyperventilation continues? |
Have the patient breathe into a bag or some other re-breathing device.
As the concentration of exhaled carbon dioxide increases in the air
breathed, and respiratory alkalosis will be minimized. |
| Where is the Larynx located? |
It begins at the base of the tongue and ends at the beginning of the
trachea. |
| In a stable patient how often should you check vital signs and record
them? |
Every 15 minutes while the inhalation conscious sedation procedure is
in progress. |
| Most dental analgesia is obtained between what percent of nitrous
oxide? |
25-50%. Sometimes your dentist may find it necessary to exceed the 50%
N2O concentration to achieve the desired level of analgesia. |
| What happens when you palpate a pulse? |
You are feeling the wave transmission and not a "spurt" of blood going
through that artery. |
| The concentration of oxygen should never go below what %? |
30% |
| What would you do in an emergency? |
Always decrease or terminate the nitrous oxide while increasing the
oxygen concentration. |
| Explain the maintenance phase? |
This phase begins when the desired level of sedation is obtained,
continues for the indicated duration of the procedure, and terminates as
the nitrous oxide is turned "off" position |
| Oxygen delivery equipment are? |
Continuous flow types and the safest. |
| What can affect the sedation procedure for children? |
Often, children will be present with hyperplasia of the adenoid
lymphatic tissue which may partially or completely obstruct this part of
the conducting airway. This factor could influence the nasal inhalation
conscious sedation procedure. |
| What are physiologic vital sign? |
heart rate and rhythm, respiratory rate and blood pressure. |
| If the patient has slurred or incoherent speech they are considered?
|
OVERSEDATED |
| What is the BEST management for a adverse reaction? |
Is a reassurance and calming of the patient.1st you must obtain and
re-focus the patients attention to you. It is important to ask the patient
to SLOW their breathing by taking a "SLOW DEEP BREATH". Attempt to talk
slowly and calmly to the patient. |
| How is air mixing utilized? |
by placing a fan in the opt, then the levels will drop up to 25ppm |
| Some people exhibit HYPEREXCITABLE due to? |
FEAR, hyperventilation, and excess movement. |
| Explain the oxygen fail safe? |
Modern machines are required to have a mechanism which shuts off or
prevents nitrous oxide deliverery without oxygen flowing. |
| What is Analgesia? |
The diminution or production of incresed tolerance to pain in the
conscious patient. |
| Oropharyngeal obstruction may occur? |
When a person who experiences routine sleep or in a patient who falls
asleep in the chair or becomes sedated. |
| What is the difference between the hood and the full mask? |
The hood covers only the nose and is not as efficent as the full mask
in gas delivery but it rarely produces patient anxiety and obviously
provides for work to easily occur in the mouth. |
| During the maintenance phase of nitrous oxide sedation the patient
must? |
AT ALL TIMES REMAIN CONSCIOUS AND ALERT |
| What are the positive factors of nitrous? |
safe with few side effects and
Agent has analgesia properties |
| Name three minor complications? |
Excessive perspiration
Increased Expectoration
Shivering |
| What do some patients exhibitunder N2O sedation? |
hyperexcitable |
| Increased temperature is usally the result of? |
increased cellular metabolism with the cause of being :infection" |
| If your diastolic pressure is >115 mm Hg you would have? |
SEVERE HYPERTENSION |
| How do you classify hypertensive? |
The blood pressure must be measured and averaged 2 or more times on 2
separate occasions. |
| What size of cuff would you use on a 1-4 yesr old? |
6-7 cm |
| A baseline temperature of 101 degrees or greater should be? |
medical evaluated prior to a dental procedure by the dentist |
| Name a objective symptoms (signs) that may be associated with the
inhalation sedation procedure? |
Eyelid "blink" is decreased |
| What should you do if a patient develops an irregular rhythm during
pre-treatment phase? |
It should be considered as a potential emergency requiring the
immediate attention of the dentist. Sudden death may occur if the
abnormality is severe. |
| When does Post-Treatment Phase begin? |
When the dental procedure is completed and the nitrous oxide gas is
turned off at the machine. |
| What is the mechanism called used to shut of the machine if there is
no oxygen? |
Fail Safe |
| What are normal finding during nitrous? |
Paresthesia, Numbness, tingling in the fingers,toes and perioral areas
|
| What is a possibility of a bounding pulse? |
It may indicate an increase in stroke volume as seen in exertion or an
emotional state or a decrease in vascular compliance as seen in rigidity
of the arteries. |
| What is the purpose of the mouth (TONGUE) ? |
The purpose of routine inhalation conscious sedation procedures. the
mouth is an accessory respiratory passage. |
