How to use this book vii

Acknowledgements ix

1 Introduction 1

Definition of conscious sedation 1

Why dental sedation is used 2

Bibliography 4

2 Medico-legal aspects of dental sedation 5

Introduction 5

Recommendations currently in place when providing dental sedation 7

Medico-legal considerations when providing dental sedation 11

Bibliography 18

3 Role of the dental nurse and equipment 19

Introduction 19

Role of the dental nurse 19

Intravenous sedation 21

Inhalation sedation 39

Oral sedation 42

Transmucosal (off-licence) sedation 45

Note 45

Clinical monitoring and equipment used 45

Conclusion 51

Bibliography 62

4 Patient selection 63

Introduction 63

The assessment appointment 63

Medical history 64

Physical examination 64

Dental history 65

Social history 67

Conclusion 67

Bibliography 67

5 Types of sedation 68

Introduction 68

Intravenous sedation 69

Inhalation sedation 82

Oral sedation 109

Bibliography 113

6 Medical emergencies 114

Introduction 114

Prevention of medical emergencies 114

Legal aspects dealing with medical emergencies 116

Dealing with medical emergencies 116

Common medical emergencies 125

Signs and symptoms of medical emergencies 126

Medical emergencies 126

Cardiac emergencies 130

Choking and aspiration 135

Epilepsy 137

Hypoglycaemia 139

Fainting/syncope 140

Note 141

Airway control and ventilation 141

Conclusion 149

Bibliography 153

7 Essential anatomy 155

Introduction 155

The blood 155

The heart 158

The respiratory system 160

The dorsum of the hand and the antecubital fossa 169

Bibliography 172

Index 173