The American Academy of Pediatrics recently revised the guidelines for dental sedation for children, during and after the procedure. The safety of the patient is the top priority.
First the new policy outlines the goals of dental sedation.
The goals of sedation in the pediatric patient for diagnostic and therapeutic procedures are as follows: (1) to guard the patient’s safety and welfare; (2) to minimize physical discomfort and pain; (3) to control anxiety, minimize psychological trauma, and maximize the potential for amnesia; (4) to modify behavior and/or movement so as to allow the safe completion of the procedure; and (5) to return the patient to a state in which discharge from medical/dental supervision is safe, as determined by recognized criteria.
The new guidelines announce the new criteria for pediatric sedation in a dental office.
During deep sedation and/or general anesthesia of a pediatric patient in a dental facility, there must be at least 2 individuals present with the patient throughout the procedure. These 2 individuals must have appropriate training and up-to-date certification in patient rescue, as delineated below, including drug administration and PALS or Advanced Pediatric Life Support (APLS). One of these 2 must be an independent observer who is independent of performing or assisting with the dental procedure. This individual’s sole responsibility is to administer drugs and constantly observe the patient’s vital signs, depth of sedation, airway patency, and adequacy of ventilation.
It is important to recognize an independent observer specifically trained must be present during the procedure. They must be permitted by state regulations, such as a Certified Registered Nurse Anesthetist (CRNA).
The independent observer must, at a minimum, be trained in PALS (or APLS) and capable of managing any airway, ventilatory, or cardiovascular emergency event resulting from the deep sedation and/or general anesthesia. The independent observer must be trained and skilled to establish intravenous access and draw up and administer rescue medications. The independent observer must have the training and skills to rescue a nonbreathing child; a child with airway obstruction; or a child with hypotension, anaphylaxis, or cardiorespiratory arrest, including the ability to open the airway, suction secretions, provide CPAP, insert supraglottic devices (oral airway, nasal trumpet, or laryngeal mask airway), and perform successful bag-valve-mask ventilation, tracheal intubation, and cardiopulmonary resuscitation.
Just like the American Academy of Pediatrics, safety is our top priority at Blue Sky Solutions. If your child or loved one has anxiety when going to the dentist, unable to sit for a long period of time, or needs extensive dental work, contact Blue Sky Solution for more information.
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