Intro-Medically Complex Pt.

kukuhkjhh's version from 2017-02-12 17:26

Section 1

Question Answer
How many Americans have high BP? How many have their condition under control1 out of 3 (75mil) have high BP, only about half (54%) have their condition under control
How many Americans have Diabetes ?29.1 million
What is the leading global cause of deathCVD disease
What is the future of dental medicine ?Post-natal stem cell research, gene therapy transfer and links between oral health and other body systems are reshaping dental practice in the 21st century
Why should dentist be aware of the medically complex patient?Oral health professionals can positively impact general health outcomes
What is the 64/38 rule ?This is the proportion of patients who visited dental practices BUT NOT general health care providers
T/F Dental practices can serve as alternate sites of opportunity to identify health concerns among diverse groups of US patients TRUE
What 5 adverse things is oral disease related to?1. coronary heart disease 2. stroke 3. adverse pregnancy outcomes 4. diabetes 5. bacterial pneumonia
Who is the fastest growing age group?people over 65
What % of americans report fair/poor health?11%
Wht % of population has a chronic medical disease?16%
What is medically complex patient? (7) 1. Pt. with a known disease 2. Pt. with an undetected medical condition 3. Pts. who have recovered from a medical condition 4. Pts. who are taking meds 5. Pts. who are following a special diet 6. Pts. who may transmit disease 7. Pts. who are in need of special dental care
What are the 4 risks of treating medically complex pts. ?1. medications 2. risk of infection 3. risk of bleeding 4. risk of medical emergency
What are the big ways to assess the risks of a patient ?1. Take a good medical history 2. Diagnostic processes 3.
What is a part of the diagnostic process ? (3) 1. obtain the health history 2. preform a clinical exam 3. obtain radiographic and lab data
What is the responsibility of every clinician BEFORE diagnostic, anesthetic or therapeutic procedures ?Medical risk assessment
What are the 1st 3 reasons for the medical risk assessment 1. to minimize risk of adverse events in the dental office resulting from dental TX 2. to ID pts. who need further medical assessment and management 3. to ID pts. for whom specific pre-op therapies or TX modifications will minimize risk, including postponing elective TX
What are the last 2 reasons for the medial risk assement ?4. To ID appropriate anesthetic technique, intra-operative procedure monitoring and post - procedure management 5. to discuss TX procedures with pts. , outlining risks and benefits, in order to obtain informed consent and determine need for additional anxiolysis
What % of patients are ASA 1 across all ages ?78%
What is % of paris are ASA 1 by 65 ?55%

Section 2

Question Answer
What are the dental modifications for an ASA 1 patient ?no modifications to dental care
What are the precautions when treating an ASA 2 pt?may or may not require modifications to dental care
What are the precautions when treating an ASA 3 pt?would generally require modifications to dental care
What are the precautions when treating an ASA 4 patient ?always requires modifications to dental care
What is an ASA 2 pt?*pt. with mild systemic disease that does not interfere with day to day activity / * pt. that has a significant health risk factor / * pt. on a systemic medication to manage/treat systemic disease
What ASA is a pt. who has a significant health risk factor (i.e. smoking, alcohol abuse, obesity?) ASA 2
What is an ASA 3 patient ?Pt. with moderate to severe systemic disease that is NOT incapacitating but that may alter day to day activity// * Pt. with significant pharmacological concerns (drug interactions/ actions)
What is an ASA 4 pt?*pt. with severe systemic disease that may be inacpaciting / * pt with severe pharmacological concerns ( actions/interactions)
What is an example of an ASA 2 pt?1. Stage 1/2 HTN, well controlled 2. Type 2 DM 3. Cardic murmer 4. Drug allergy 5. controlled asthma 6. well controlled seizure disorder 7. mild COPD 8. HIV + without systemic manifestations
What is an example of an ASA 3 pt. ?1. Type 1 DM 2. stable angina pectoris 3. MI within past year 4. compensated CHF 5. AIDS 6. Significant COPD 7. anti-coagualation
What is an example of an ASA 4?1. ESRD 2. advanced AIDS 3. organ transplant 4. immunosupprsed indiviusals 5. BM/XRT pts 6. coagulopathy

Section 3

Question Answer
What is the susceptibility to infection based on ?based on underlying medical disease or medications
Know thy ABCDEs?(4 As, 1 B, 1 C, 2 D, and 2E) A-antibiotics (prophylactic or therapeutic) , A- anesthesia (type and vasoconstrictor), A- Anxiety, A- Allergy , B- bleeding , C- chair position , D- Drugs (interactions, adverse effects, side effects, allergies) , D-devices (prosthetic valves, joints, stents, pacers, AV fistulas) , E- equipment (X-rays, ultrasonic scalers, electrosurgery, oxygen) , E- emergencies ( potential for occurrence)
look at slide for before, during and after dental tx
What is success based on the ? the outcome or the procedure?success will based on the OUTCOMES not procedures