General anaesthesia for adult special care dental patients
08:45 Registration, refreshments and exhibition
09:30 Welcome
16:45 Close
The day will cover:
General anesthesia in Special Care Dentistry – what, why, how…. (60 min session)
Aim
The aim of this sessions will be to cover the relevance of general anaesthesia within special care dentistry, consider when it may be appropriate and outline some of the key considerations and guidelines which are relevant in this area.
Learning objectives
By the end of this activity, the participant should be able to…
- Have an awareness of what general anaesthesia entails and when its use may be appropriate
- Be aware of the indications for general anesthesia within the context of special care dentistry
- Understand the key guidelines which are relevant to delivering dental care under general anesthesia within special care dentistry
- Be aware of the key treatment planning factors which must be considered when delivering dental care under general anesthesia.
Learning content
This session will outline general anesthesia within special care dentistry. It will explore when general anesthesia may be indicated and will give an outline of the key guidance documents related to delivery of dental care under general anaesthesia. It will consider some of the key treatment planning factors when planning and delivering dental care in a special care setting.
Development outcomes: A, B, C, D
Caroline Graham, Consultant in Special Care Dentistry and Clinical Lead, Tees Community Dental Service, North Tees and Hartlepool NHS Foundation Trust
GA’s for Special Care Dentistry – going with the flow…safely (45 min session)
Aim
We will consider anaesthesia for adult special care patients, with a focus on risk reduction. It will cover planning for medically complex patients, planning a safety-aware service and managing behaviourally challenging patients safely.
Learning objectives
By the end of this activity, the participant should be able to:
- Identify and gather information for patients at increased anaesthetic risk
- Seek anaesthetic advice where appropriate
- Plan pre- and post-operative pathways with safety in mind
- Interface with other healthcare providers to manage risk.
Learning content
This session examines physical health conditions associated with anaesthetic risk in this patient group, and how to gather relevant information for planning where to treat higher risk patients.
The session will explore strategies for managing behaviourally challenging patients safely and consider difficulties commonly encountered with planning a pre-op and referral pathway for community services.
Kim Soulsby, Clinical Lead for Anaesthetics, Royal Berkshire NHS Foundation Trust
A case-based approach to designing and developing a general anaesthetic special care service (45 min session)
Aim
The session will give an overview of the design and development considerations for a Special Care Dentistry (SCD) General Anaesthetic (GA) service, using a case-based approach with real clinic cases.
Learning objectives
By the end of this activity, the participant should be able to:
- Outline staffing, equipment and facility requirements for a SCD GA list with consideration of their organisational, administrative and financial impacts
- To discuss special requirements that need to be considered when designing a SCD GA service and what additional training/education staff require to deliver this to a high standard
- To outline the use of audit and QI to monitor and improve the quality of a GA service
- To outline areas for future developments in SCD and GA services.
Learning content
The session will give attendees an overview of the design and development considerations for a SCD GA service. It will have a particular focus on the special requirements of a SCD GA service and the unique needs for this patient group. Organisational challenges that can present when delivering a GA service and the need for staff training and quality assurances will be reviewed. The session will finally look to the future and how GA services may develop and adapt to better serve the patient group.
Elizabeth Cheales, Specialist in Special Care Dentistry, Oxford Health NHS Foundation Trust and Lucy Taylor, Specialty Registrar (StR) in special care dentistry
Ethical and legal barriers for a patient with a learning disability requiring dental and medical treatment under GA - getting it right (45 min session)
Aim
To understand the ethical and legal complexities encountered when managing the dental and medical care of a patient with severe autism and learning disability who was refusing to leave his house under General Anaesthesia (GA). To be able to apply this information and experience to similar cases encountered.
Learning objectives
By the end of this activity, the participant should be able to:
- Understand the legal implications of working with the Court of Protection
- Be aware of different ways to overcome social and medical difficulties related to treating patients under GA
- How to co-ordinate multiple professions to enhance the management of patients with severe learning disabilities and autism.
Learning content
This session will present a case-study, showing how a patient faced numerous ethical dilemmas and complex legal involvement in accessing dental care due to his learning disability and social circumstances. The session highlights awareness of legal and clinical challenges that may affect practitioners.
Hamza Hossenally, Specialist/Consultant in Special Care Dentistry, Whittington Health NHS Trust/Barts Health NHS Trust
Sleep apnoea and its relevance to dentistry (60 min session)
Aim
Understand the prevalence and causes of sleep apnoea, its potential risks for patients undergoing dental treatment with sedation or anaesthesia, how to spot it, how to mitigate those risks and understand the dental professional's role in referral.
Learning objectives
By the end of this activity, the participant should be able to:
- Understand why we sleep and why sleep is so important
- Understand the aetiology and consequences of sleep apnoea
- Identify patients who are at risk.
- Be aware of the methods of diagnosing and treating sleep apnoea
Learning content
This session will focus on sleep apnoea (obstructive, central, altitude), anaesthetic consequences of OSA and diagnosis and treatment of OSA.
David Dawson, Consultant in Anaesthesia and Sleep Medicine, Bradford Teaching Hospitals NHS Foundation Trust
