This document defines and describes levels of sedation, from minimal to general anesthesia. It discusses behaviour management techniques, pharmacological and non-pharmacological approaches to sedation. Specific agents that can be used for sedation are outlined, including nitrous oxide, desflurane, sevoflurane, hydroxyzine, promethazine, diazepam, meperidine, ketamine, midazolam and propofol. Their indications, benefits, limitations and risks are provided. Guidelines for preparing for and administering sedation are also reviewed.
This document discusses conscious sedation techniques for pediatric dental patients. It defines conscious sedation and different levels of sedation from minimum to deep sedation. The objectives, indications, contraindications and special considerations for conscious sedation in children are outlined. Requirements for patient assessment, equipment, monitoring and sedation techniques including nitrous oxide/oxygen sedation are described. Various sedative agents, their doses, benefits and limitations are also detailed.
This document provides information on conscious sedation techniques for pediatric dental patients. It defines conscious sedation and describes the different levels of sedation from minimum to general anesthesia. Common agents used for sedation like nitrous oxide, sevoflurane and midazolam are discussed along with their indications, benefits and limitations. Requirements for providing safe sedation like pre-sedation assessment, monitoring equipment and recovery are outlined. Inhalation sedation using nitrous oxide and oxygen is described in detail including administration techniques and planes of sedation. The document concludes by listing some references.
This document provides information on general anesthesia, local anesthesia, and conscious sedation including:
- The key differences between general anesthesia, local anesthesia, and conscious sedation.
- The American Society of Anesthesiologists patient physical status classification system.
- The stages of general anesthesia according to Guedel and Gillespie.
- Common routes of administration for anesthesia including intravenous, inhalation, intramuscular, and oral.
- Common drugs used for intravenous and inhalation anesthesia like propofol, sevoflurane, and ketamine.
- Guidelines for preoperative, intraoperative, and postoperative care when providing general anesthesia.
This document discusses guidelines for conscious sedation during periodontal and implant surgical procedures. It defines different levels of sedation from mild to moderate. Guidelines are provided for patient evaluation, monitoring, and recovery for mild and moderate sedation using oral, inhalation, or intravenous routes. Common drugs used for mild oral sedation are discussed along with dosing guidelines. Moderate sedation techniques including oral, inhalation, and intravenous administration are outlined. Safety and monitoring are important to avoid deeper levels of sedation than intended.
This document discusses the history and definitions of conscious sedation. It describes the goals and indications for conscious sedation, as well as contraindications and the importance of patient assessment and preparation. Common agents used for conscious sedation are discussed, with a focus on nitrous oxide and oxygen sedation. The pharmacokinetics, pharmacodynamics, and adverse effects of nitrous oxide are summarized.
This document discusses pediatric procedural sedation and analgesia (PSA). It defines sedation as a reduction in awareness while analgesia is a reduction in pain perception. PSA involves using sedatives, analgesics, and dissociative agents to relieve anxiety and pain from medical procedures. The targeted depth of sedation and choice of agents depends on factors like the procedure, pain level, and patient characteristics. Common medication categories used include sedatives, analgesics, dissociative medications, inhalation medications, and reversal agents. Adverse events and contraindications are discussed for each category.
This document provides information on conscious sedation techniques used in dentistry. It defines different levels of sedation including minimal, moderate, and deep sedation. Nitrous oxide/oxygen is described as the most commonly used agent for conscious sedation due to its rapid onset, short duration of action, and high rate of patient acceptance. The document reviews the pharmacokinetics, pharmacodynamics, advantages, adverse effects and guidelines for appropriate use of nitrous oxide in dental procedures. Equipment requirements and administration techniques are also outlined.
This document discusses conscious sedation techniques for pediatric dental patients. It defines conscious sedation and different levels of sedation from minimum to deep sedation. The objectives, indications, contraindications and special considerations for conscious sedation in children are outlined. Requirements for patient assessment, equipment, monitoring and sedation techniques including nitrous oxide/oxygen sedation are described. Various sedative agents, their doses, benefits and limitations are also detailed.
This document provides information on conscious sedation techniques for pediatric dental patients. It defines conscious sedation and describes the different levels of sedation from minimum to general anesthesia. Common agents used for sedation like nitrous oxide, sevoflurane and midazolam are discussed along with their indications, benefits and limitations. Requirements for providing safe sedation like pre-sedation assessment, monitoring equipment and recovery are outlined. Inhalation sedation using nitrous oxide and oxygen is described in detail including administration techniques and planes of sedation. The document concludes by listing some references.
This document provides information on general anesthesia, local anesthesia, and conscious sedation including:
- The key differences between general anesthesia, local anesthesia, and conscious sedation.
- The American Society of Anesthesiologists patient physical status classification system.
- The stages of general anesthesia according to Guedel and Gillespie.
- Common routes of administration for anesthesia including intravenous, inhalation, intramuscular, and oral.
- Common drugs used for intravenous and inhalation anesthesia like propofol, sevoflurane, and ketamine.
- Guidelines for preoperative, intraoperative, and postoperative care when providing general anesthesia.
This document discusses guidelines for conscious sedation during periodontal and implant surgical procedures. It defines different levels of sedation from mild to moderate. Guidelines are provided for patient evaluation, monitoring, and recovery for mild and moderate sedation using oral, inhalation, or intravenous routes. Common drugs used for mild oral sedation are discussed along with dosing guidelines. Moderate sedation techniques including oral, inhalation, and intravenous administration are outlined. Safety and monitoring are important to avoid deeper levels of sedation than intended.
This document discusses the history and definitions of conscious sedation. It describes the goals and indications for conscious sedation, as well as contraindications and the importance of patient assessment and preparation. Common agents used for conscious sedation are discussed, with a focus on nitrous oxide and oxygen sedation. The pharmacokinetics, pharmacodynamics, and adverse effects of nitrous oxide are summarized.
This document discusses pediatric procedural sedation and analgesia (PSA). It defines sedation as a reduction in awareness while analgesia is a reduction in pain perception. PSA involves using sedatives, analgesics, and dissociative agents to relieve anxiety and pain from medical procedures. The targeted depth of sedation and choice of agents depends on factors like the procedure, pain level, and patient characteristics. Common medication categories used include sedatives, analgesics, dissociative medications, inhalation medications, and reversal agents. Adverse events and contraindications are discussed for each category.
This document provides information on conscious sedation techniques used in dentistry. It defines different levels of sedation including minimal, moderate, and deep sedation. Nitrous oxide/oxygen is described as the most commonly used agent for conscious sedation due to its rapid onset, short duration of action, and high rate of patient acceptance. The document reviews the pharmacokinetics, pharmacodynamics, advantages, adverse effects and guidelines for appropriate use of nitrous oxide in dental procedures. Equipment requirements and administration techniques are also outlined.
Conscious sedation is a technique used to relax patients for dental procedures while keeping them awake. The most common method is nitrous oxide delivered via nasal hood. Characteristics of conscious sedation include the patient remaining awake but impaired. Children are more easily sedated than adults. Risks include unintended loss of consciousness. Evaluation of patients includes medical history, physical exam, and determining ASA class. Preparations include instructions, fasting, and having a responsible adult. Techniques include inhalation of nitrous oxide, intravenous drugs, and oral drugs. Proper equipment and monitoring of sedation levels is important. Post-sedation instructions warn against driving or operating machinery for 18 hours.
Sedation of children for medical procedures can be done safely and has benefits over general anesthesia. The article discusses the classification of sedation depth, commonly used sedation drugs for children and their properties, and guidelines for safe sedation from NICE. Drugs like propofol, midazolam, ketamine, remifentanil, clonidine and dexmedetomidine can be used alone or combined under an expert's supervision depending on the procedure and child's needs. Close monitoring is needed during sedation, especially for deep sedation, and personnel must be trained to manage potential complications.
This document discusses the role of anesthesiologists during cath lab procedures and the types of anesthesia used. It outlines the necessary equipment, medications, monitoring, and considerations for different procedures. Anesthesiologists must plan carefully with cardiologists and be prepared to manage airways and treat potential complications while patients are sedated or anesthetized for cath lab exams and interventions.
This document discusses conscious sedation techniques for dental procedures. It defines levels of sedation from mild to moderate. Mild sedation can be achieved through oral medications like benzodiazepines or nitrous oxide. Moderate sedation requires intravenous medications and more monitoring. The document reviews specific oral and intravenous medication options and techniques for achieving different levels of sedation. It provides clinical guidelines for patient evaluation, monitoring, and recovery when using sedation. Potential sedation failures are also discussed. The goal of sedation techniques is to reduce anxiety and discomfort during dental procedures while maintaining patient safety.
This document discusses conscious sedation, including why it is used, types of sedation, drugs used, risks, and how to manage complications. The main points are:
1. Sedation is used to relieve anxiety, stress and pain for medical procedures. It can cause relaxation, drowsiness or altered mental states depending on the person.
2. Common types of sedation include minimal, moderate and deep sedation. Drugs like benzodiazepines and opioids are often used due to their sedative and analgesic effects.
3. Risks include respiratory depression, loss of airway, and vomiting/aspiration. Equipment and drugs like flumazenil and naloxone are
This document discusses conscious sedation, including why it is used, types of sedation, drugs used, risks, and how to manage complications. The main points are:
1. Sedation is used to relieve anxiety, stress and pain for medical procedures. It can cause relaxation, drowsiness or altered mental states depending on the person.
2. Common types of sedation include minimal, moderate and deep sedation. Drugs like benzodiazepines and opioids are often used due to their sedative and analgesic effects.
3. Risks include respiratory depression, loss of airway reflexes, and vomiting. Equipment and drugs like flumazenil and naloxone are needed
This document discusses conscious sedation, including why it is used, types of sedation, drugs used, risks, and how to manage complications. The main points are:
1. Sedation is used to relieve anxiety, stress and pain for medical procedures. It can cause relaxation, drowsiness or altered mental states depending on the person.
2. Types of sedation include minimal, moderate and deep sedation. Drugs like benzodiazepines and opioids are commonly used due to their sedative and analgesic effects.
3. Risks include respiratory depression, loss of airway, and vomiting/aspiration. Equipment and drugs like flumazenil and naloxone are needed
Procedural sedation involves using short-acting sedatives and analgesics to reduce pain and anxiety during medical procedures, while closely monitoring the patient. Common agents used include midazolam, fentanyl, propofol, ketamine, etomidate, and nitrous oxide. The goal is moderate sedation where the patient is relaxed but responsive. Precautions are taken for patients at risk of complications. Monitoring during and after sedation is important to watch for adverse effects, which are usually minor when done properly.
Anaesthetic considerations for intraoperative neurophysiological monitoringSamir Elkafrawy
The document discusses neurophysiologic intraoperative monitoring (NIOM) and its use during spinal and brain surgeries to reduce risks to peripheral nerves. It covers the basic NIOM techniques of electromyography, motor and somatosensory evoked potentials, motor evoked potentials, and electroencephalography. It also discusses the four phases of general anesthesia - premedication, induction, maintenance, and recovery - and considerations for each phase like medications administered. Finally, it provides details on ideal properties of anesthetic drugs and the history and use of inhalation, intravenous, and muscle relaxant anesthetics.
The document discusses procedural sedation, including definitions of different levels of sedation, monitoring requirements, safety considerations, common sedating agents like nitrous oxide, midazolam, fentanyl and their properties, and discharge criteria after a procedure. Procedural sedation involves administering sedatives to induce a depressed level of consciousness while maintaining cardiorespiratory function to allow medical procedures with little patient reaction or memory.
This document provides an overview of procedural sedation and analgesia (PSA). It discusses the concept and goals of PSA, sedation grading scales, clinical decision making, patient assessment and preparation. It also covers considerations for special populations like pregnant, younger and elderly patients. Common sedation drugs, complications and discharge criteria are reviewed. PSA is described as administering drugs to facilitate a procedure while preserving airway reflexes and stability, for patient comfort and efficiency. Risks of oversedation are discussed.
Summary:
Regional anesthetic techniques are increasing in popularity because of the improved recovery profiles
Intravenous adjuvants can provide patient comfort
Titrated infusion of rapid and short acting sedative drugs should enhance patient safety
Vigilant monitoring, supplemental oxygen, and the availability ressucitation equipment are strongly recommended
This document discusses pediatric procedural sedation. It covers preparation, medications commonly used for sedation including midazolam, fentanyl, ketamine and propofol, monitoring during sedation, and techniques to aid in safe and effective sedation like pre-oxygenation and use of adjuncts with ketamine. The right agent is chosen based on the procedure and patient needs, aiming for a level of sedation allowing the procedure while maintaining safety. Close monitoring both during and after is emphasized.
This document provides guidelines for moderate sedation/analgesia (conscious sedation). It defines levels of sedation from minimal to general anesthesia. Moderate sedation involves patients responding purposefully to verbal commands with spontaneous breathing. The guidelines discuss patient evaluation, monitoring, personnel, equipment, drugs and discharge criteria for providing moderate sedation. Proper patient screening, credentialed practitioners and personnel, appropriate facilities and emergency equipment are emphasized to minimize risks while allowing benefits of sedation for certain medical procedures.
This document provides guidelines for moderate sedation/analgesia (conscious sedation). It defines the different levels of sedation from minimal to general anesthesia. Moderate sedation is described as a drug-induced depression where patients can respond to commands. It outlines safety procedures for patient evaluation, monitoring during procedures, qualifications of medical personnel, facilities requirements, and discharge criteria. The goal is to allow clinicians to provide sedation benefits to patients safely by minimizing risks.
Conscious sedation involves using sedatives and analgesics to minimize pain and discomfort during minor medical procedures while maintaining a level of consciousness where the patient can respond appropriately. It allows for safe and effective procedures with quick recovery times. The American Society of Anesthesiologists defines four levels of sedation from minimal to general anesthesia. Conscious or moderate sedation involves purposeful responses to verbal commands and unaffected ventilatory and cardiovascular functions. Patients are closely monitored during and after procedures for side effects like nausea, headaches, or respiratory depression.
The document discusses premedication practices in anesthesia. It notes that while premedication was originally used to counter side effects of early anesthetics like ether, the focus is now on improving patient wellbeing and satisfaction. Benefits of premedication include reducing anxiety, nausea, acidity and autonomic responses. Key drugs discussed are benzodiazepines like midazolam and antiemetics. Optimal timing, safety considerations and special populations like pediatrics are also reviewed.
Conscious sedation is a technique used to relax patients for dental procedures while keeping them awake. The most common method is nitrous oxide delivered via nasal hood. Characteristics of conscious sedation include the patient remaining awake but impaired. Children are more easily sedated than adults. Risks include unintended loss of consciousness. Evaluation of patients includes medical history, physical exam, and determining ASA class. Preparations include instructions, fasting, and having a responsible adult. Techniques include inhalation of nitrous oxide, intravenous drugs, and oral drugs. Proper equipment and monitoring of sedation levels is important. Post-sedation instructions warn against driving or operating machinery for 18 hours.
Sedation of children for medical procedures can be done safely and has benefits over general anesthesia. The article discusses the classification of sedation depth, commonly used sedation drugs for children and their properties, and guidelines for safe sedation from NICE. Drugs like propofol, midazolam, ketamine, remifentanil, clonidine and dexmedetomidine can be used alone or combined under an expert's supervision depending on the procedure and child's needs. Close monitoring is needed during sedation, especially for deep sedation, and personnel must be trained to manage potential complications.
This document discusses the role of anesthesiologists during cath lab procedures and the types of anesthesia used. It outlines the necessary equipment, medications, monitoring, and considerations for different procedures. Anesthesiologists must plan carefully with cardiologists and be prepared to manage airways and treat potential complications while patients are sedated or anesthetized for cath lab exams and interventions.
This document discusses conscious sedation techniques for dental procedures. It defines levels of sedation from mild to moderate. Mild sedation can be achieved through oral medications like benzodiazepines or nitrous oxide. Moderate sedation requires intravenous medications and more monitoring. The document reviews specific oral and intravenous medication options and techniques for achieving different levels of sedation. It provides clinical guidelines for patient evaluation, monitoring, and recovery when using sedation. Potential sedation failures are also discussed. The goal of sedation techniques is to reduce anxiety and discomfort during dental procedures while maintaining patient safety.
This document discusses conscious sedation, including why it is used, types of sedation, drugs used, risks, and how to manage complications. The main points are:
1. Sedation is used to relieve anxiety, stress and pain for medical procedures. It can cause relaxation, drowsiness or altered mental states depending on the person.
2. Common types of sedation include minimal, moderate and deep sedation. Drugs like benzodiazepines and opioids are often used due to their sedative and analgesic effects.
3. Risks include respiratory depression, loss of airway, and vomiting/aspiration. Equipment and drugs like flumazenil and naloxone are
This document discusses conscious sedation, including why it is used, types of sedation, drugs used, risks, and how to manage complications. The main points are:
1. Sedation is used to relieve anxiety, stress and pain for medical procedures. It can cause relaxation, drowsiness or altered mental states depending on the person.
2. Common types of sedation include minimal, moderate and deep sedation. Drugs like benzodiazepines and opioids are often used due to their sedative and analgesic effects.
3. Risks include respiratory depression, loss of airway reflexes, and vomiting. Equipment and drugs like flumazenil and naloxone are needed
This document discusses conscious sedation, including why it is used, types of sedation, drugs used, risks, and how to manage complications. The main points are:
1. Sedation is used to relieve anxiety, stress and pain for medical procedures. It can cause relaxation, drowsiness or altered mental states depending on the person.
2. Types of sedation include minimal, moderate and deep sedation. Drugs like benzodiazepines and opioids are commonly used due to their sedative and analgesic effects.
3. Risks include respiratory depression, loss of airway, and vomiting/aspiration. Equipment and drugs like flumazenil and naloxone are needed
Procedural sedation involves using short-acting sedatives and analgesics to reduce pain and anxiety during medical procedures, while closely monitoring the patient. Common agents used include midazolam, fentanyl, propofol, ketamine, etomidate, and nitrous oxide. The goal is moderate sedation where the patient is relaxed but responsive. Precautions are taken for patients at risk of complications. Monitoring during and after sedation is important to watch for adverse effects, which are usually minor when done properly.
Anaesthetic considerations for intraoperative neurophysiological monitoringSamir Elkafrawy
The document discusses neurophysiologic intraoperative monitoring (NIOM) and its use during spinal and brain surgeries to reduce risks to peripheral nerves. It covers the basic NIOM techniques of electromyography, motor and somatosensory evoked potentials, motor evoked potentials, and electroencephalography. It also discusses the four phases of general anesthesia - premedication, induction, maintenance, and recovery - and considerations for each phase like medications administered. Finally, it provides details on ideal properties of anesthetic drugs and the history and use of inhalation, intravenous, and muscle relaxant anesthetics.
The document discusses procedural sedation, including definitions of different levels of sedation, monitoring requirements, safety considerations, common sedating agents like nitrous oxide, midazolam, fentanyl and their properties, and discharge criteria after a procedure. Procedural sedation involves administering sedatives to induce a depressed level of consciousness while maintaining cardiorespiratory function to allow medical procedures with little patient reaction or memory.
This document provides an overview of procedural sedation and analgesia (PSA). It discusses the concept and goals of PSA, sedation grading scales, clinical decision making, patient assessment and preparation. It also covers considerations for special populations like pregnant, younger and elderly patients. Common sedation drugs, complications and discharge criteria are reviewed. PSA is described as administering drugs to facilitate a procedure while preserving airway reflexes and stability, for patient comfort and efficiency. Risks of oversedation are discussed.
Summary:
Regional anesthetic techniques are increasing in popularity because of the improved recovery profiles
Intravenous adjuvants can provide patient comfort
Titrated infusion of rapid and short acting sedative drugs should enhance patient safety
Vigilant monitoring, supplemental oxygen, and the availability ressucitation equipment are strongly recommended
This document discusses pediatric procedural sedation. It covers preparation, medications commonly used for sedation including midazolam, fentanyl, ketamine and propofol, monitoring during sedation, and techniques to aid in safe and effective sedation like pre-oxygenation and use of adjuncts with ketamine. The right agent is chosen based on the procedure and patient needs, aiming for a level of sedation allowing the procedure while maintaining safety. Close monitoring both during and after is emphasized.
This document provides guidelines for moderate sedation/analgesia (conscious sedation). It defines levels of sedation from minimal to general anesthesia. Moderate sedation involves patients responding purposefully to verbal commands with spontaneous breathing. The guidelines discuss patient evaluation, monitoring, personnel, equipment, drugs and discharge criteria for providing moderate sedation. Proper patient screening, credentialed practitioners and personnel, appropriate facilities and emergency equipment are emphasized to minimize risks while allowing benefits of sedation for certain medical procedures.
This document provides guidelines for moderate sedation/analgesia (conscious sedation). It defines the different levels of sedation from minimal to general anesthesia. Moderate sedation is described as a drug-induced depression where patients can respond to commands. It outlines safety procedures for patient evaluation, monitoring during procedures, qualifications of medical personnel, facilities requirements, and discharge criteria. The goal is to allow clinicians to provide sedation benefits to patients safely by minimizing risks.
Conscious sedation involves using sedatives and analgesics to minimize pain and discomfort during minor medical procedures while maintaining a level of consciousness where the patient can respond appropriately. It allows for safe and effective procedures with quick recovery times. The American Society of Anesthesiologists defines four levels of sedation from minimal to general anesthesia. Conscious or moderate sedation involves purposeful responses to verbal commands and unaffected ventilatory and cardiovascular functions. Patients are closely monitored during and after procedures for side effects like nausea, headaches, or respiratory depression.
The document discusses premedication practices in anesthesia. It notes that while premedication was originally used to counter side effects of early anesthetics like ether, the focus is now on improving patient wellbeing and satisfaction. Benefits of premedication include reducing anxiety, nausea, acidity and autonomic responses. Key drugs discussed are benzodiazepines like midazolam and antiemetics. Optimal timing, safety considerations and special populations like pediatrics are also reviewed.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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concioussedation.pptx
1.
2. ⦿Definition: It is defined as means by which the
dental health team effectively and efficiently
performs dental treatment and thereby instils a
positive dental attitude. (Wright,1975)
4. A minimally depressed level of consciousness,
that retains the patient’s ability to maintain an
airway independently & respond appropriately
to physical stimulation & verbal commands.
(AMERICAN DENTAL
ASSOCIATION,1993)
5. ⦿Sedation/analgesia is defined by a continuum of
“levels” ranging from minimally impaired
consciousness to unconsciousness.
⦿The following terminology refers to the different
levels of sedation intended by the practitioner
Minimum sedation
Moderate
sedation
Dissociative
sedation
Deep
sedation
General
anaesthesia
6.
7. Adrug-induced state during which
⦿Patients respond normally to verbal commands.
⦿Cognitive function & coordination may be
impaired.
⦿V
entilatory and cardiovascular functions are
unaffected.
⦿Note: This level is rarely adequate for an infant
or young child undergoing
sedation for a procedure.
8. A drug-induced depression of consciousness
during which
⦿ Patients respond purposefully to verbal
commands, either alone or accompanied by
light tactile stimulation.
⦿ Airway is patent, & spontaneous ventilation is
adequate.
⦿Cardiovascular function is usually maintained.
9. ⦿ (Ketamine) A cataleptic state occurs with both
profound analgesia and amnesia while
maintaining protective airway reflexes,
spontaneous respirations, and cardiopulmonary
stability.
⦿
10. A drug induced depression of consciousness
during which
⦿ Patients cannot be easily aroused but respond
purposefully after repeated verbal or painful
stimulation.
⦿The ability to independently maintain
ventilatory function, may be impaired.
⦿ Patients may require assistance in maintaining
a patent airway.
⦿Cardiovascular function is usually maintained.
⦿ A state of deep sedation may be accompanied
by partial or complete loss of protective airway
reflexes.
11. A drug-induced loss of consciousness during
which patients are not arousable, even by
painful stimulation.
The ability to independently maintain
ventilatory function is often impaired.
Patients often require assistance in
maintaining a patent airway, and positive
pressure ventilation may be required
because of depressed spontaneous
ventilation or drug-induced depression of
neuromuscular function.
Cardiovascular function may be impaired.
12. Conscious sedation General anaesthesia
Patient is cooperative , but
anxious and fearful
Patient is uncooperative
Generally no extensive
investigations are required
At least basic investigations are
must.
No premedication is required Premedication is required
Patient is conscious and contact
is maintained
Patient is unconscious.
Airway is maintained Ventilation is required
NPO not required NPO strict
Recuperation period is 1-2
minutes
Time consuming procedure
13. Benett (1978) has stated the objectives to be:
⦿The patient’s mood should be altered.
⦿ pain threshold should be increased.
⦿Amnesia should occur.
⦿Patient should be cooperative.
⦿Patient should be conscious, respond to verbal
stimuli.
⦿All protective reflexes are intact.
⦿Vital signs stable and normal.
14. ⦿Dental anxiety and phobia
⦿Prolonged or traumatic dental procedures
⦿Medical conditions potentially aggravated by
stress
⦿Medical conditions affecting the patient’s
ability to cooperate
⦿Patient lacking cooperation because of lack of
psychological or emotional maturity
⦿Special needs
15. ⦿ Chronic obstructive pulmonary disease
(COPD), epilepsy, & bleeding disorders.
⦿ Uncooperative or unwilling patients.
⦿ Unaccompanied patients..
⦿ Prolonged surgery.
⦿ Lack of equipment or inadequate personnel.
16. ⦿Knowledge of the agents to be used
⦿Consent
⦿No lack of equipment
⦿Planned rationale for use of sedation
17. ⦿Obtaining patient history & information.
Age, weight, height
Health history
Systems review
⦿Airway evaluation
⦿ASA Physical Status Classification
⦿Instructions to parents preop & postop.
⦿Adequate documentation of the sedation
experience with monitoring of vital signs.
18. SUCTION FUNCTIONING SUCTION APPARATUS
OXYGEN ADEQUATE OXYGEN SUPPLY & FLOWMETERS TO
ALLOW ITS DELIVERY
AIRWAY APPROPRIATE AIRWAY (ENDOTRACHEAL TUBES, FACE
MASK)
PHARMACY ALL BASIC DRUDS NEEDED TO SUPPORT LIFE DURING
AN EMERGENCY
MONITORS FUNCTIONING PULSE OXIMETER
EQUIPMENT SPECIAL EQUIPMENT OR DRUGS FOR A PARTICULAR
CASE (E.G. DEFIBRILLATOR)
( AAP/ AAPD GUIDELINES , 2006)
The acronym “SOAPME” offers a routine
for preparing for sedation.
20. Name of
agent
Dose Indications and benefits Limitations and risks
Nitrous oxide •Used for mild to moderate levels of
anxiety
•Rapid onset, early elimination and
recovery
•Duration of action can be controlled
•Agent has weak potency
•Not used in children with severe
behaviour problems
•Cannot be used in
claustrophobic patients,
respiratory tract infections
Desflurane Inhaled
concentration
should be 6-8%
•Rapid induction of anaesthesia and
rapid emergence
•Produces direct skeletal muscle
relaxation
•No hepatotoxicity and no
nephrotoxicity
•Irritating to airway in awake
patients
•Result in transient tachycardia
•Concentration dependent
increase in respiratory rate and
decrease in tidal volume
Sevoflurane Inhaled
concentration
should be 2-4%
•Non irritating to airway
•Does not produce tachycardia
•No heapatotoxicity
•Hypotension and decrease in
cardiac output
•Concentration dependent
increase in respiratory rate and
decrease in tidal volume
•Renal injuries and renal
impairment have been reported
21. Name of agent Dose Indications and
benefits
Limitations and
risks
Hydroxyzine 1-2mg/kg •Mild sedative along with
antiemetic and anticholinergic
action
•Potentiate narcotic and CNS
depressant
•Better used in combination with
other drugs
•Adverse reaction in form of
extreme drowsiness and dry
mouth , hypersensitivity
Promethazine 0.5-1.1mg/kg •With sedative and
antihistaminic properties
•Potentiate other CNS
depressant
•Better used in combination with
other drugs
•For mild level of anxiety only
•To be used with caution in
children with history of asthma
and sleep apnoea
•Should be avoided in seizure
prone patients
Diazepam 0.2-0.5mg/kg To a maximum
dose of 10mg
•Safe agent for mild to moderate
anxiety particularly in children
with cerebral palsy, mental
retardation
•Children less than 6 years of
age
•Not effective in severe anxiety
when used alone
•Common adverse reaction in
form of ataxia and prolonged
CNS effect
Meperidine 1-2.2mg/kg Best used in combination with
other agent
•Poor oral absorption
•Should be used with extreme
caution in patients with hepatic/
renal diseases or history of
seizures
22. Name of agent Dose Indications and
benefits
Limitations and
risks
Ketamine 10 and 50mg/ml Dissociative
anaesthesia
Midazolam 1 and 5 mg/ml •Possesses
hypnotic,
anticonvulsant,
muscle relaxant
properties as
well as being
antegrade
amnesic and
anxiolytic
•Little data for
effective dose in
paediatric
context
•Used mainly for
short procedure
23. Name of agent Dose Indications and
benefits
Limitations and
risks
Propofol 2mg/kg bolus iv
for induction
9mg/kg for
maintenance
•Suited for
outpatient
surgeries as
incidence of
postoperative
nausea and
vomiting is low
•Respiratory
depression
25. ⦿It quickly agent crosses the pulmonary
membrane & enters the blood stream.
⦿It is an insoluble drug & remains unchanged in
blood & does not combine with any blood
elements.
⦿ Since N2O does not break down, so peak
clinical effects may be seen within 3-5 minutes.
⦿There is no biotransformation & 99% of gas is
rapidly eliminated by the lungs.
26. ⦿It produces nonspecific CNS depression.
⦿At concentrations 30-50%, N2O will produce a
relaxed & dissociated patient who is easily
susceptible to suggestion.
⦿ Moderate sedation is achieved when N2O
concentration is 50% .
⦿ At concentrations greater than 60%, patients
may experience discoordination, ataxia,
giddiness, and increased sleepiness.
⦿ Concentrations greater than 50% are not to be
used in dental practice.
⦿The gas is non-irritating to the respiratory tract
27. ⦿Nitrous oxide is a good analgesic, even 20%
produces analgesia equivalent to that produced
by conventional doses of morphine.
⦿A mixture of 70% N2O+25-30% O2+0.2-2%
another potent anesthetic is employed for most
surgical procedure.
28. ⦿The Central Storage System
The nitrous oxide tanks are always marked
blue for identification, and the oxygen tanks
are green.
⦿Nitrous Oxide-Oxygen Machine
⦿BreathingApparatus
Nasal hood
⦿Safety Features
31. •Bag is filled with 100% oxygen and delivered to the
patient for 2/3 minutes at an appropriate flow rate of 5-6
L /minute.
•Once the proper flow rate is achieved, the N2O can be
introduced by slowly increasing the concentration at
increments of 10% to 20% to achieve the desired level.
•SENSATIONS- Felt are floating, giddy feeling with
tingling of digits. The eyes will take on a distant gaze
with sagging eyelids.
32. ⦿ When this state is reached, the local anaesthetic may
be given. Once this is completed, the concentration
can be reduced to 30% nitrous oxide and 70% oxygen
or lower. The patient can now be maintained and
monitored & procedure carried out.
⦿Recovery can be achieved quickly by reverse
titration. Once the sedation is reversed, the patient
should be allowed to breathe 100% oxygen for 3-5
minutes.
⦿ The patient should be allowed to sit. Even though
psychomotor effects return to normal within 5 to 15
minutes, it is not advisable to allow teenage patients
to drive themselves.
33. ⦿Plane 1:Moderate sedation andAnalgesia
Achieved with concentration of 5-25%N2O
⦿Plane 2: Dissociation sedation and analgesia
Concentration of 25-45% N2O
⦿Plane 3: Total anaesthesia
Achieved with 45-65% concentration
Lightest plane
Somnolent state
Deepest plane
⦿Plane4
34. ⦿Nausea and vomiting
⦿Middle ear pressure can increase pain in
patients with acute otitis media.
⦿Neurotoxicity, renal/liver toxicity.
⦿Diffusion hypoxia