About this course

Learning Objectives

• : Participants will be able to identify and demonstrate basic airway maneuvers such as the head-tilt/chin-lift and jaw-thrust to alleviate partial airway obstruction, utilizing appropriate techniques for patients with and without suspected cervical spine injuries.
• Participants will learn the indications for and how to effectively use advanced airway devices including supraglottic airways, endotracheal tubes, and surgical airways, with an emphasis on correct placement and the verification process to ensure proper gas exchange and prevent complications.
• Participants will be able to distinguish between the clinical features of partial and complete airway obstructions and implement appropriate interventions, including the use of basic and advanced airway maneuvers and adjuncts.
• Trainees will understand the red flags indicating an at-risk airway and learn how to quickly assess and manage scenarios such as cannot intubate, cannot ventilate (CICV), using a structured approach including the use of emergency surgical airways.
• Participants will gain knowledge of the various types of airway adjuncts (e.g., oropharyngeal and nasopharyngeal airways), their indications, contraindications, and the proper techniques for insertion, ensuring safety and minimizing complications like trauma and aspiration.
• Participants will be able to describe and implement a comprehensive pre-procedure evaluation, including the use of a preoperative sedation/anesthesia checklist, ensuring adherence to required documentation such as medical history, medication review, and ASA classification as outlined by Texas Administrative Code §110.13.
• Learners will identify and document continuous monitoring requirements during anesthesia, including consciousness, oxygenation, ventilation, and circulation, in accordance with Texas Administrative Code §§108.7 and 108.8, ensuring that details such as oxygen saturation, respiratory rate, and blood pressure are recorded at specified intervals.
• Participants will understand and apply the guidelines for post-procedure monitoring, ensuring that all necessary observations and evaluations are continually recorded until the patient meets discharge criteria, including the continuous assessment of the patient’s level of consciousness, oxygen saturation, and vital signs.
• Trainees will gain knowledge of the legal requirements for anesthesia records and documentation, including the specific provisions of the Texas Administrative Code that govern the preparation and maintenance of anesthesia documentation in dental practice.
• : Participants will learn to assess and document whether a patient meets the defined discharge criteria post-anesthesia, as per AAPD guidelines and Texas Administrative Code, and ensure that all discharge instructions are communicated both verbally and in writing to the patient or caregiver.
• : Participants will be able to identify the signs and symptoms of common emergencies such as airway obstruction, acute coronary syndrome, allergic reactions, bronchospasm, cardiac arrest, and seizures, and apply immediate management techniques.
• Learners will understand and execute dental office emergency protocols, including the use of medical crisis checklists, to enhance the median percentage of interventions performed effectively, as demonstrated in the provided study.
• : Trainees will learn how to correctly use emergency medical equipment such as defibrillators and administer appropriate emergency medications, focusing on the correct dosages and routes of administration as per the scenario needs.
• : Participants will be familiarized with the legal requirements and compliance standards for managing emergencies in dental settings, ensuring documentation and adherence to protocols as per health regulations.
• : Participants will master the ABCDEs (Airway, Breathing, Circulation, Drugs, and Defibrillation) of basic life support tailored to dental office emergencies, emphasizing quick assessment and responsive actions to stabilize patients until further medical help arrives.
• Participants will identify and effectively manage common sedation-related emergencies such as airway obstruction, bronchospasm, emesis and aspiration, acute coronary syndrome, and cardiac arrest, utilizing appropriate techniques for each condition.
• Learners will master airway management techniques including head tilt, jaw thrust, use of airway adjuncts such as nasal or oral airways, and advanced methods like endotracheal intubation and cricothyrotomy, especially in response to airway obstruction or laryngospasm.
• Trainees will learn the indications for and administration of emergency medications such as succinylcholine, epinephrine, rocuronium, and lidocaine spray, focusing on appropriate dosages and routes for rapid stabilization of the patient.
• Participants will understand how to effectively utilize emergency protocols and equipment, including the deployment of an automated external defibrillator (AED) and the execution of CPR, in cases of cardiac arrest within the dental office.
• Trainees will learn to assess ongoing emergency conditions like myocardial infarction and anaphylaxis, manage these situations with initial care, and prepare for safe and prompt transportation to emergency facilities if needed.
• : Participants will learn how to prepare the dental office for anesthesia, including setting up anesthesia machines, ensuring proper sizes and connections for source gases, and preparing for emergency situations with appropriate medications and equipment on-hand.
• Trainees will gain expertise in pediatric anesthesia induction techniques, managing anxious or fearful children during induction, and using preoperative medications effectively to ease the induction process.
• : Participants will understand how to maintain anesthesia safely using inhalation anesthetics like sevoflurane and isoflurane, and how to transition to recovery by managing the timing and dosage of anesthetic reduction and adjunct medications like fentanyl and Zofran.
• Learners will be trained on the protocols for postoperative care including assessing patient recovery, managing patient discharge, and ensuring patients receive appropriate postoperative instructions.
• : Participants will learn how to assess both the physical and mental state of patients, including understanding and overcoming language and mental barriers, to determine the most suitable sedation method for dental procedures.
• Trainees will understand how to apply the American Society of Anesthesiologists (ASA) Physical Status Classification System to evaluate preoperative risks and decide on the appropriateness of office-based sedation for patients with various comorbid conditions.
• : Participants will learn to identify common medical conditions such as asthma, diabetes mellitus, and obesity, and understand their implications for sedation and anesthesia, including adjustments in perioperative management.
• Learners will gain knowledge on how to handle sedation for patients with special considerations such as those with severe asthma, poorly controlled diabetes, or significant obesity, focusing on optimizing perioperative safety and minimizing complications.
• Trainees will be equipped with strategies to manage potential sedation-related challenges in diverse patient scenarios, including those with recent upper respiratory infections or those taking medications that could impact sedation safety and efficacy.
• : Participants will learn to identify clinical situations and patient conditions such as dental anxiety, medical conditions affected by stress, and special needs that warrant the use of conscious sedation to manage patient care effectively.
• : Trainees will be equipped with knowledge on different methods of administering conscious sedation, including oral, intramuscular, intravenous, and inhalation routes, and understand the specific clinical scenarios where each method is most appropriate.
• : Participants will understand how to perform a thorough pre-sedation evaluation, including airway assessment, fasting protocols, and patient pharmacodynamics, to ensure patient safety and effective sedation.
• Learners will identify potential risks and complications associated with conscious sedation, such as hypoventilation, airway obstruction, and cardiovascular depression, and learn strategies for their prevention and management.
• Trainees will learn the importance of effective communication and cooperation between the dental and anesthesia teams during sedation procedures, particularly in scenarios involving a shared airway.

Learning Levels

• Level 1 Minimal Sedation
• Level 2 Moderate Sedation
• Level 3 Moderate Sedation
• Level 4 Deep Sedation

Target Audience

Course Instructor(s)

• 

  Vincent Young MD

  Private Practice Anesthesiologist, Dallas, TX

  Following the fulfillment of his Air Force Scholarship, Dr. Young relocated to Dallas and embarked on his career in hospital-based anesthesia. Initially, he assisted Dr. Garza at a surgery center, periodically extending his services to provide anesthesia in his office approximately every two months. With the shift away from hospitals offering operating room time to pediatric dental practitioners, and by word of mouth, Dr. Young's Office-Based Anesthesia (OBA) practice has flourished into a bustling daily operation. Recognizing the potential anxiety associated with sedation in this environment, he is eager to impart his extensive experience, empowering you to practice with confidence while delivering essential patient care.

• 

  Ronald Garza, DDS

  Director of DSTAR, Private Practice Pediatric Dentist

  Dr. Garza is committed to continuing education, because he understands the importance of staying at the forefront of an ever-evolving profession that constantly challenges his knowledge and skills. Continuing education keeps him informed and updated with the most advanced techniques and technology, and ensures that he meets the highest standard of care in pediatric dentistry.

Disclosure