Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
The term serial extraction describes an orthodontic treatment procedure that involves the orderly removal of selected deciduous and permanent teeth in a predetermined sequence
The term serial extraction describes an orthodontic treatment procedure that involves the orderly removal of selected deciduous and permanent teeth in a predetermined sequence
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
Behavioral Management Technique For Patient With Special Needs DrGhadooRa
done by : ( ABCD'S &G )
alaa ba-jafar
abrar alshahranii
sahab filfilan
nada alharbi
shahd rajab
Ghadeer suwaimil
I hope that you enjoy and you benefit❤
American Academy of Pediatrics Holds Its 2015 National Conference Dr Jay Schwartz
Since 2007, experienced pediatrician Dr. Jay Schwartz has treated young patients as the owner of Collin County Pediatrics in Frisco, Texas. An involved medical professional, Dr. Jay Schwartz maintains membership in the American Academy of Pediatrics, which oversees various programs and activities to promote the health and well-being of all children.
INTRODUCTION
DEFINITIONS
CLASSIFICATIONS
COMMUNICATION WITH GERIATRIC PATIENT
Dr.MM HOUSE CLASSIFICATION
AGE & NUTRITION
FACTORS AFFECTING NUTRITION
Dr. Janet Bauer of Loma Linda University addresses the growing issue of dental neglect in seniors, particularly those in early to mid-stage dementia who can no longer practice good dental hygeine without assistance. The presentation was part of the June 7, 2013 Glenner Symposium on Elder Abuse and Neglect for San Diego County health care professionals.
Diagnosis and treatment planning in completely edentulous patientsDr ARYA SUDARSANAN
If you like to view in my youtube channel Dr Aaryas Vlogs please click on these links for parts 1 to 4
https://youtu.be/jBT4UloMqoM
https://youtu.be/cBwQpjW0yD0
https://youtu.be/EO_MSE2wle4
https://youtu.be/1UXMNQ0gPho
Thanks for watching..........
Please do like, share and subscribe my channel for more videos..........
different classification of complete denture patients, includes house classification
for more
https://youtu.be/aaJ6gpQohcs
https://youtu.be/REMKSUty0cE
https://youtu.be/fv3_tWZPJIU
https://youtu.be/GeZIbCwqKYU
if you want me to make ppt on some topic do let me know on the comment section of my youtube channel
diagnostic aids part 1 diagnosis, examination, BMR, EMG.docxDr.Mohammed Alruby
Introduction:
Proper treatment plane depends on prompt diagnosis, good clinician should have a bird’s eyes to first identify the problem and find its etiology
Definitions:
= Grabber and Rackosi: defined diagnosis as:
Recognition and systemic designation of anomalies, the practical synthesis of the finding, permitting therapy to be planned and identification to be determined
=a continuous evaluation process in orthodontics starting right from the first interaction with the patient continuing through different stages till end of treatment and course follow up visits
Goal of orthodontic diagnosis:
Is to produce a comprehensive description of the patient’s problem and then to synthesis the various elements of description into a rational problem list
Diagnostic aids:
Data required for orthodontic diagnosis are derived from routine essential diagnostic aids and also from supplemental aids when needed, Graber categorized the diagnostic aids into essential and supplemental aids
Essential:
- Case history
- Study models
- Certain radiographs: periapical, bite wing, panoramic radiograph
- Facial photographs
- Intra-oral photographs
Supplemental:
- Specialized radiographs: occlusal of maxilla and mandible, lateral cephalogram
- Hand &wrist radiograph
- Electromyography
- Endocrine test
- Basal metabolic rate
Case history:
Complete case history includes all the relevant information derived from the patient and parents and essential for planning
Personal details:
Name:
The patient’s name should be recorded for the purpose of identification and communications
Calling the patient by his/her name not only establishes a good report but also imparts confidence in the patient mind about treatment providers
In case of children, it might help to know their pet problems
Age:
= certain malocclusion occurring during growth period are transient and self-correcting
= growth modification procedures such as functional appliances can be carried out during growth periods
= surgical respective procedures such as orthognathic surgery are best carried out after cessation of growth
= chronological age is important for the maintaining of shedding and eruption time tables as well
Gender:
= recording gender of the patient is important for treatment planning, females are observed to precede males in growth related events such as onset of growth spurt, eruption of the teeth and onset of puberty
= gender may also have a bearing on patient’s compliance toward certain types of orthodontic treatment
Occupation and address:
Occupation of patient / or parents gives an idea about socioeconomic condition which might affect the selection of orthodontic appliances and can give an idea about awareness
Address of patient determine the sociality of the patient and this effect on the treatment because some countries have normally bi-maxillary protrusion and also determine the awareness of patient about treatment and oral hygiene
Patient behavior:
Behavior of patient depend on: patient
Bagaimanakah perkhidmatan pergigian pasca pandemik Covid-19 di Malaysia?
Slides presentation ini adalah sebahagian daripada bahan promosi yang disampaikan kepada masyakarat umum di Kampar sepanjang jerayawara sempena Minggu Promosi Kesihatan Pergigian 2020 pada bulan Ogos yang lalu.
Taklimat berkenaan ServQual, Survey of Quality di Klinik Pergigian Kerajaan KKM. Survey ini dilakukan untuk mengetahui pandangan pesakit/pelanggan luaran terhadap perkhidmatan yang diberikan supaya langkah-langkah penambahbaikan boleh dijalankan.
Taklimat berkenaan MERS-COV (Middle East Respiratory Syndrome-Corona Virus) berkenaan pengurusan sample yang diambil dari pesakit.
Virus ini mula tersebar di Arab Saudi, dan perhatian lebih perlu diberikan kepada jemaah-jemaah yang baru pulang dari Umrah di Makkah & Madinah, Arab Saudi.
Taklimat berkenaan MERS-COV (Middle East Respiratory Syndrome-Corona Virus) dari aspek Paediatrik.
Virus ini mula tersebar di Arab Saudi, dan perhatian lebih perlu diberikan kepada jemaah-jemaah yang baru pulang dari Umrah di Makkah & Madinah, Arab Saudi.
Taklimat berkenaan MERS-COV (Middle East Respiratory Syndrome-Corona Virus) - 12 Julai 2013
Virus ini mula tersebar di Arab Saudi, dan perhatian lebih perlu diberikan kepada jemaah-jemaah yang baru pulang dari Umrah di Makkah & Madinah, Arab Saudi.
Dr chongck mers cov media briefing (pkp's slide) 5 july 2013Syafiq Ali
Taklimat berkenaan MERS-COV (Middle East Respiratory Syndrome-Corona Virus) oleh Dr ChongCK bertarikh 5 Julai 2013 di IPK Bangsar.
Virus ini mula tersebar di Arab Saudi, dan perhatian lebih perlu diberikan kepada jemaah-jemaah yang baru pulang dari Umrah di Makkah & Madinah, Arab Saudi.
Dr ChongCK MERS-COV - taklimat PKP 5 julai 2013 @ IPK, bangsarSyafiq Ali
Taklimat berkenaan MERS-COV (Middle East Respiratory Syndrome-Corona Virus) oleh Dr ChongCK bertarikh 5 Julai 2013 di IPK Bangsar.
Virus ini mula tersebar di Arab Saudi, dan perhatian lebih perlu diberikan kepada jemaah-jemaah yang baru pulang dari Umrah di Makkah & Madinah, Arab Saudi
Slide Ceramah LNPT Jun 2013 di HRPB Ipoh.
Kandungan : Tugasan & peranan Pegawai Yang Dinilai, Pegawai Penilai Pertama & Pegawai Penilai Kedua.
Disampaikan oleh Pegawai dari Jabatan Perkhidmatan Awam (JPA)
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
4. “That part of Dentistry concerned with the
oral health of people adversely affected by
intellectual disability, medical, physical or
psychiatric issues.” (RACDS)
5. “That part of dental practice which deals
with patients where intellectual disability,
medical, physical or psychiatric conditions
require special methods or techniques to
prevent or treat oral health problems, or
where such conditions necessitate special
dental treatment plans.” (ADA)
6. “The oral health management of patients
adversely affected orally by intellectual or
physical disability and medical or psychiatric
issues or, more often, a combination of a
number of these factors, where such
conditions necessitate a modified delivery of
oral health care for patients’ total health
well-being”
7. SND as a specialty:
2003-New Zealand and Australia (SND)
(Hospital Dentistry and Paediatric Dentistry)
2008- United Kingdom (SCD)
(Dentist with special interest in SCD)
2008- Malaysia (SND)
8.
9. Dr Jane Chalmers:
Passed away on 7th
Dec 2008 after a
battle of cancer. Key
organizer
instrumental of
ASSCID. First
Australian who
received PhD and
became an associate
professor in that field
10. Dr Peter King BDS MDS
FICD
Working at Hunter New
England Health Service as
a specialist providing oral
health services to people
with special needs. Peter
was the
first President of the
Australian Society of
Special Care in Dentistry
and is on the editorial
board of the International
Journal of Disability and
Oral Health.
11. Impairment
as any loss or abnormality of physiology or
anatomical structure or function
Disability
any restriction or lack (resulting from an
impairment) of ability to perform an activity
in a manner or within the range considered
normal for a human being
International Classification of Functioning, Disability and Health
12. Handicap
seen as the disadvantage for a given
individual, resulting from an impairment or
a disability, which limits or prevents the
fulfillment of a role that is normal
(depending on age, sex, social and cultural
factors) for that individual
International Classification of Functioning, Disability and Health
13. Intellectual disability
A disability characterized by significant
limitations both in intellectual functioning and in
adaptive behavior, which covers many everyday
social and practical skills. This disability
originates before the age of 18
(AAIDD website, 2011)
Examples:
Down syndrome
Global developmental delay
14. Physical disability
Either loss or missing body parts and/or
functions including hemiplegia, paraplegia,
tetraplegia which affecting activities of daily
living such as personal care, movement and
body posture
(JKM website,2011)
Examples of etiology:
Spinal Cord Injury
Stroke
Traumatic brain injury
Cerebral Palsy
15. Medical complex
Receiving treatment or medication for any other
long-term conditions or ailments and still
restricted in everyday activities
Any other long-term conditions resulting in a
restriction in everyday activities
16. Psychiatric/psychological disorders
a broad range of problems, with different symptoms.
However, they are generally characterized by some
combination of abnormal thoughts, emotions, behaviour
and relationships with others (WHO website, 2011)
Examples:
Schizophrenia
Depression
17. Geriatric dentistry
Focuses on the diagnosis, prevention and
treatment of oral diseases in adults who, because
of their medical condition or old age, are
handicapped or institutionalised and require
special management during their dental
treatment
23. Unmet treatment needs due to barriers to
dental care
Increase in numbers of the elderly population
and people with disabilities with multiple
medical conditions leading to impairment
Absence of follow up and maintenance care
24. Individual barriers:
Lack of perceived
needs
Anxiety or fear
Financial
considerations
Lack of access
Dental profession:
Inappropriate manpower
resources
Uneven geographical
distribution
Training inappropriate
to changing needs and
demands
Insufficient sensitivity
to patient attitudes and
needs
25. Society:
Insufficient public
support of attitudes
conducive to health
Inadequate oral
health care
facilities
Inadequate oral
health manpower
planning
Insufficient support
for research
Government:
Lack of political will
Inadequate
resources
Low priority
Unattractive
problems
* KEY - EDUCATION
26. “The majority of problems for all could be
addressed by an ideal public health system.
Unfortunately, the situation in many
countries is far from ideal, and the demand
for secondary and tertiary care continues to
grow. This is particularly true of the
population with special needs where an
accumulation of unmet need continues to be
discovered” (Faulks & Hennequin, 2006)
27. Akta Orang Kurang Upaya 2008:-
'Orang Kurang Upaya' termasuklah
mereka yang mempunyai
kekurangan jangka panjang fizikal,
mental, intelektual, atau deria
yang apabila berinteraksi dengan
pelbagai halangan, boleh menyekat
penyertaan penuh dan berkesan
mereka dalam masyarakat.
28. 1. Orang kurang upaya hendaklah
mempunyai hak untuk menikmati
kesihatan atas asas kesetaraan dengan
orang upaya
2. Majlis, sektor swasta dan pertubuhan
bukan kerajaan hendaklah mengambil
langkah yang sesuai untuk memastikan
orang kurang upaya mendapat akses
kepada perkhidmatan kesihatan,
termasuk rehabilitasi berkaitan
kesihatan,yang peka gender
29. Hospital-based specialty
Focusing on individual 16 year old and above
Providing clinical support at the local community
health centers-visiting and consultation,
combined clinic with other dental disciplines
Referral to specialist in SND – patients with
complex problems (ASA III/ASA IV) or issues with
multiple co-morbidities and polypharmacy
Demonstrate appropriate clinical skills in
relation to behavioural management strategies,
understanding legislation and ethics, positive
attitude towards PWD
30. • Hospital Kuala Lumpur
• Hospital Serdang
Current SND
service
provision
(2011 and
2012)
• General dentistry services with modification in accordance with
patient’s condition
• For examples: Comprehensive dental treatment (restorative
works, RCT, routine periodontal therapy, simple extraction
/MOS, biopsy ) under GA, sedation or with behavioral
modifications strategies. Preventive strategies including close
monitoring of oral hygiene care performed by carer at home.
Treatment/
procedures
• Physical disabilites
• Psychologic/psychiatric issues
• Complex medical conditions
• Intellectual/behavioural issues
• Patient who requires conscious sedation/GA
Type of
patients
31. Treatment modifications
Hearing and visual impairment
Wheelchair users
Managing the challenging behaviour
Ensuring airway patency
Referral for treatment and consultation by
specialists
Inter-collaboration with other health care
providers
Physical interventions
32. All patients in ASA III and IV
category requiring oral
health care, including
geriatric patients
Patients with intellectual
impairments/disabilities
requiring dental treatment
under sedation or general
anaesthesia or unable to
receive treatment at the
community dental setting
33. Patients with physical disabilities with
significant co-morbidities and mortality
conditions
All in-patients requiring oral health
assessment prior to organ transplant
procedure
All in-patients requiring an assessment or
oral health care prior to cardiac surgery
34. All in-patients undergoing head and neck
radiotherapy/ chemotherapy, during and
after the therapy
Patients with psychiatric and psychological
conditions with associated medical
conditions which compromising the oral
health status
35. Patients referred by the community dental
centers or rehabilitation centers because
they cannot be managed at the community
dental setting due to the complex medical
issues or behavioural problems.
36. ASA DEFINITION DENTAL TX MODIFICATIONS
I Normal , healthy patient None
II A patient with mild
systemic disease, e.g.
well controlled diabetes,
anticoagulation, mild
asthma, hypertension,
epilepsy, pregnancy,
anxiety.
Medical advice may be helpful.
Often few treatment
modifications needed, unless GA
or major surgery is needed.
37. ASA DEFINITION DENTAL TX MODIFICATIONS
III A patient with severe
systemic disease limiting
activity but not
incapacitating, e.g. chronic
renal failure, epilepsy with
frequent seizures,
uncontrolled hypertension,
uncontrolled diabetes,
severe asthma, stroke.
Medical advice is helpful.
Dental care should focus on elimination
of acute infection and chronic disease,
prior to medical/surgical procedure
(e.g. haemodialysis patients). Patients
are often best treated in a hospital-
based clinic where medical expert is
available.
38. ASA DEFINITION DENTAL TX MODIFICATIONS
IV A patient with incapacitating
disease that is a constant
threat to life, e.g. cancer,
unstable angina or recent
myocardial infarct,
arrhythmia, recent
cerebrovascular accident, end-
stage renal disease, liver
failure.
Medical advice is indicated.
All potential dental problems
should be corrected prior to
medical/ surgical procedure to
deal with basic problems (e.g.
radiotherapy to head and neck, or
organ transplant). Patients are
often best treated in a hospital-
based clinic where medical expert
is available. Emergency dental
care indicated.
39. ASA DEFINITION DENTAL TX MODIFICATIONS
V Moribund patient not expected to
live more than 24 hours with or
without treatment.
Medical advice is essential.
Patients are often best treated
in a hospital-based clinic
where expert medical support
is available. Emergency dental
care indicated.
43. Frail and functionally dependent (relying on
the carers for activities of daily living
(ADL) such as bathing, eating and tooth-
brushing)
Neurologic and cognitive impairments
Communication and behavioural problems
Increased chronic medical conditions
including polypharmacy
Chronic psychiatric/psychological conditions
44. Nutritional/swallowing problems
Poor motivation towards oral health care
Elderly who is categorized as ASA III or ASA IV
Patients require dental management under
conscious sedation or general anaesthesia
45. Clinical presentation of patient (either one or more):
-Intellectual/ cognitive/ developmental problem
-Physical/ mobility/ manual dexterity issues
Emotional/ mental issues
-Chronic medical problem – history and current problems
-Polypharmacy
Impact of the above conditions on
oral health
Impact on coping
with dental
treatment at a
normal setting
Appropriate to
refer to SND
Impact on
performing and
maintaining oral
hygiene
Appropriate to
refer to SND
Impact of
communication or
behavioural
challenge
Appropriate to
refer to SND
Impact on
provision of
treatment
Risk of
medications esp.
Bisphospho-nate
therapy
Appropriate to
refer to SND
Risk of bleeding
and/or healing
problems
Appropriate to
refer to SND
Require sedation
or GA
Appropriate to
refer to SND
46. • Consultation
• Urgent treatment
• Further management
Reason for
referral
• Referral letters with complete
patient’s details and relevant
documents including valid OKU
card/photocopy or guarantee
letter
The
responsibilities
of the referring
clinicians
• Prioritizing the patients
• Review the referrals in
accordance to referral guidelines
• Advice for referred patients
The
responsibilities
of the referral
centers