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Recognition and Management of Complications during Minimal and Moderate Sedation * PART ONE OF A TWO PART PROGRAM
You will receive 4 unit(s) of continuing education credit upon successful completion of this course. The registration fee is only $152.00

Description:
In this course particular emphasis is placed on patient monitoring and airway management. (Basic life support at the health care level is recommended).

Author:
American Dental Association, Continuing Education and the ADA Council on Dental Education
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Learning Objectives:
Upon completion of this course participants should be able to:
  1. Recognize sedation levels and general anesthesia in terms of clinical characteristics and influence on respiratory and cardiovascular function.
  2. Describe essential features of preoperative assessment for patients undergoing dental treatment under sedation or general anesthesia.
  3. Identify principles of patient monitoring distinguishing requirements for moderate sedation versus deep sedation/general anesthesia.
  4. Explain proper airway maintenance during sedation and general anesthesia.
  5. Discuss the proper use of devices for oxygenation and ventilation.
  6. Describe the pathogenesis, recognition and appropriate management of possible complications associated with moderate sedation, including essential pharmacology of emergency drugs that may be required.


Abstract:
The course is designed to train the practicing dentist in the proper recognition and management of respiratory complications that may be associated with the use of moderate sedation. *This is Part 1 of a two -part program. It is recommended that the participant complete Part 1 prior to enrollment in Part 2 (within 12 mos.). Part 2 is a five- hour hands on workshop consisting primarily of laboratory exercise and clinical simulations. For part two scheduling and additional information contact the ADA at 1-800 621-8099 x2694.

Outline:
Lesson 1: Introduction and Preoperative Assessment
Lesson 2: Respiratory Monitoring
Lesson 3: Primary Assessment
Lesson 4: Supplemental Oxygenation
Lesson 5: Positive Pressure Ventilation
Lesson 6: Management of Respiratory Depression
Lesson 7: Management of Airway Obstruction
Lesson 8: Intra-operative nausea and vomiting
Lesson 9: Cardiovascular Considerations
Lesson 10: Summary and ADA Airway Algorithm
References:
  1. Eichhorn JH; Cooper JB; Cullen DJ, and et al. Standards for patient monitoring during anesthesia at Harvard Medical School. JAMA. 1986; 256:1017-1020.
  2. Rosenberg MB and Campbell RL. Guidelines for intraoperative monitoring of dental patients undergoing conscious sedation, deep sedation, and general anesthesia. Oral Surg Oral Med Oral Pathol. 1991; 71:2-8.
  3. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002;96:1004-17
  4. Keats AS. The effects of drugs on on respiration in man. Ann Rev Pharmacol Toxicol 1985;25:41-65
  5. Becker DE. The respiratory effects of drugs used for conscious sedation and general anesthesia. JADA 1989;119:153-56.
  6. Benumof JL, Dagg R, Benumof R. Critical hemoglobin desaturation will occur before return to an unparalyzed state following 1 mg/kg intravenous succinylcholine. Anesthesiology. 1997; 87:979-82.
  7. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) . Am J Respir Crit Care Med. 1995; 152:s77-s120.
  8. Cairo JM, Pilbean SP. Mosby’s Respiratory Care Equipment. 7th Edition. Philadelphia: Mosby Inc. 2004:pg 62-88.
  9. Reilly JJ, Silverman EK, Shapiro SD. Chronic obstructive pulmonary disease. In: Kasper DL, Braunwald E, Fauci AS, et al Eds. Harrison's Principles of Internal Medicine. 16th edition. New York: McGraw Hill , 2005. pg 1547-1554.
  10. Heniff MS, Moore GP, Trout A, Cordell WH, Nelson DR. Comparison of routes of flumazenil administration to reverse midazolam-induced respiratory depression in a canine model. Acad Emerg Med 1997; 4:1115-8.
  11. Sampson HA, Munoz-Furlong A., Campbell RL, et. al. Second symposium on the definition and management of anaphylaxis: summary report--second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med. 2006;47:373-80.
  12. Hazinski MF, Chameides L, Hemphill R (editors). 2005 American Heart Association: Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2005; 112(24): supplement IV1-IV196.
  13. Deihl RR, Linden D. Images in Clinical Medicine: Neurocardiogenic Syncope. N Engl J Med 1998;339:312.
  14. Thrush DN, Downs JB. Vagotonia and cardiac arrest during spinal anesthesia. Anesthesiology 1999;91:1171-73.
  15. Sibbald WJ, Paterson NA, et al. The trendelenburg position:hemodynamic effects in hypotensive and normotensive patients. Crit Care Med 1979;7:218-224.
  16. Coonan TJ, Hope CE. Cardio-respiratory effects of change of body position. Can Anaesth Soc J 1983;30:424-437.
  17. Lawson NW, Johnson JO. Autonomic nervous system: Physiology and pharmacology. In: Barash PG; Cullen BF, and Stoelting RK, Editors. Clinical Anesthesia. 5th ed. Philadelphia: Lippincott-Raven Publishers; 2006:pg 275-333.
  18. Varon J, Marik PE. The diagnosis and management of hypertensive crisis. Chest 2000;118:214-227.
  19. Gallagher, E. J. Hypertensive urgencies: treating the mercury? Ann Emerg Med. 2003 Apr; 41(4):530-1.






American Dental Association is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.