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Intravenous Conscious Sedation Policy
Effective management of pain and anxiety is of enormous importance to patients requiring dental treatment. Conscious Sedation is a fundamental component of this. Competently provided Conscious Sedation is safe, valuable and effective.
At this practice we use a wide margin of safety between Conscious Sedation and the unconscious state of general anesthesia. Conscious Sedation must not be interpreted as light general anesthesia.
Every exposure to Conscious Sedation is justified. Careful and thorough assessment of the patient ensures that correct decisions are made regarding the planning of treatment.
At this practice Conscious Sedation is undertaken with the supervision of a seditionist.
We only offer Conscious Sedation to adults and children from the age of 12 years. (In case of children we offer a single drug therapy which may sometimes limit the treatment. Please check with us for more information).
Competency based on a solid foundation of theoretical and practical supervised training, updating of skills and continuing experience ensures safe and best practice at all times.
A thorough medical and dental history is obtained and recorded prior to each course of treatment for every patient.
Patients must have an escort present at the surgery before treatment commences. That escort must stay in the waiting room whilst treatment is carried out and must take the patient home in a vehicle afterwards. Public transport is not allowed following sedation.
Patients receive careful written instructions and valid written consent is obtained before treatment is commenced.
This practice recommends fasting for 3 hours prior to sedation, in line with our local authority's instructions.
All equipment for the administration of intravenous sedation, including appropriate reversal drugs, are available in the treatment area and are appropriately maintained.
The standard technique for intravenous sedation is the use of a titrated dose of a single drug, for example a form of benzodiazepine. In rare cases it may be supplemented with a second drug because no single technique will be successful for all patients.
All drugs and syringes used in the treatment area are clearly labelled and are given according to accepted recommendations.
Stringent clinical monitoring during the procedure is always maintained and all members of the clinical team are capable of undertaking this.
Operating chairs and patient trolleys are capable of being placed in the head-down tilt position, and equipment for resuscitation from respiratory and cardiac arrest is readily available.
Training in the management of complications in addition to regularly rehearsed proficiency in life-support techniques is undertaken by all clinical staff. Retention and improvement of knowledge and skills for all clinical staff are ongoing.
Should the need for supplemental oxygen arise, it is always readily and immediately available.
Recovery from Conscious Sedation is a gradual progression from completion of treatment to discharge The Recovery Nurse supervises and monitors the patient throughout this period.
The decision to discharge the patient into the care of the escort following intravenous sedation is the responsibility of the seditionist.
The patient and escort are provided with details of potential complications, aftercare and emergency contacts.