SAAD digest
-
Midazolam is a benzodiazepine commonly used for conscious sedation in dentistry. This paper reports a state of unconsciousness in a 14-year-old girl after administration of midazolam sedation for dental treatment, which was not reversible with flumazenil. The patient remained in an Intensive Care Unit for two days, unresponsive to any stimulus. ⋯ The patient fully recovered and was discharged from hospital after 6 days. A referral to a sleeping disorder clinic was made to investigate the patient's sleeping patterns. This paper highlights the importance of sedation being provided by an appropriately trained team.
-
Conscious sedation is an integral part of modern day dental care and should be delivered through a high quality, effective and evidence-based approach. Commissioning of NHS dental services in England is currently under review by NHS England and the National Dental Commissioning Group. This group has identified the management of vulnerable people including anxious patients, as one of its priorities. ⋯ Its ethos is a"hub and spoke" model of service delivery with patient assessment delivered by experienced and well trained dental sedationists at its core. In line with the recent Francis Report fundamental standards for all aspects of dental conscious sedation practice are outlined, supported by a robust and predictable quality assurance process. This work has been shared with key stakeholders in NHS England including the Chief Dental Officer and the Head of Primary Care Commissioning.
-
In the UK, Dental General Anaesthesia (DGA) was removed from primary care at the end of 2001. Since then anxious and 'difficult' paediatric dental patients have been treated using local anaesthesia with or without conscious sedation. ⋯ Various centres have presented evidence of good clinical practice when anaesthetist-led. This study describes an audit of 500 children treated using intravenous midazolam and ketamine, by an operator-sedationist in a primary care setting.
-
Comparative Study
An audit of the sedation activity of participants following their attendance on SAAD conscious sedation courses.
The aim of this study was to analyse the results of a questionnaire given directly to participants of SAAD courses in 2011, and posted to previous participants, on their own use of conscious sedation. Apart from general interest, such data will help the SAAD Faculty to tailor the courses in future better to meet the needs of participants by providing insights into the attitudes and level of experience in sedation of course participants. Questionnaires were distributed to participants on all the 2011 SAAD courses and to all members of the dental team. ⋯ Only 3% carried out any advanced techniques. 14% (n = 81) of dentists who had completed a SAAD course previously did not go on to use conscious sedation, and possible reasons for this are discussed. Participants' overall confidence in specific areas of sedation training were rated from 'good' to 'excellent' after completion of a SAAD course. Participants completing SAAD courses believe they have gained in confidence and in knowledge, and obtained the skills required to provide conscious sedation although some identify barriers which prevent them from putting these new skills into practice.