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287 Cards in this Set
- Front
- Back
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What is the presence of any microorganism called?
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contamination
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What is contamination?
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the presence of any microorganism
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What is infection?
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Colonization of bugs (not necessarily damaging)
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What is the colonization of bugs? Is this damaging?
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infection
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What is a pathogen?
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an infectious agent
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What is an infectious agent called?
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pathogen
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How many bacteria are contained in 1 drop of saliva?
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50,000
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What is virulence?
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The ability to cause infection and damage
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What are properties of virulent bacteria?
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Easily colonizes
Grows rapidly Produces harmful substances Evades/counters body's defenses |
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What is the dose?
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number of cells of a contaminant
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What are the four types of resistance?
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Innate (skin, mucous membranes)
Mechanical (secretions, cilia) Chemical (stomach acid) Acquired (cell-mediated(antibodies)) |
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What is sterilization?
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Destruction of all microbial forms
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What are the types of sterilization and which is the most common?
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Heat (most common)
Filtration Radiation |
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What is sanitization?
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process of physical cleaning to reduce the quantity of microbes and bioburden
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What is an example of sanitization?
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Use of disinfectant and paper towels on surface
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When should sanitization be done (in relation to sterilization and disinfection)?
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Sanitization should be done before sterilization and disinfection
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What is asepsis?
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The exclusion of harmful microorganisms
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What alcohol solution is most effective?
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30% solution with alcohol and water penetrates bacteria and is more effective than 100% alcohol
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What is disinfection
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destruction of pathogenic microbes
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What is our target for cubicle preperation? Sterilization, Sanitization, or Disinfection?
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Disinfection
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What is Spaulding's Classification System
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Categorizes patient care items by potential risk for infection
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What are critical items?
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Items that pierce the skin or mucosa (explorers scalpels, burs, scalers, etc)
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What level of cleaning should be used with critical items?
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Sterilization
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What are semi-critical items?
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non-sharp items that enter the oral cavity (amalgam condensers, mirrors, reusable dental impression trays)
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What level of cleaning should be used with semi-critical items?
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Sterilization or high-level disinfection (exception: dental handpiece must be heat sterilized)
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What level of cleaning should be used for the dental handpiece?
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Heat sterilization
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What are non-critical items?
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items that don't enter the oral cavity but may be touched (bracket table, counter tops, chair controls)
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What level of cleaning should be used with non-critical items?
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Disinfection
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What are environmental items?
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Walls, Floors, etc
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What level of cleaning should be used with environmental items?
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Housekeeping (soap and water)
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What must be present in every dental office for all disinfectants?
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Material Safety Data Sheet (MSDS)
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What disinfectant is best for a dental office?
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No single disinfectant is best for every dental office
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How should a disinfectant be used?
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Read and follow label instructions
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What must be worn when using disinfectant?
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Proper PPE
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What does PPE stand for?
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Personal protective equipment
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What are the requirements for a liquid chemical cleaner?
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Surface cleaned of debris and bioburden first
Adequate contact time Correct temperature Correct pH Correct concentration |
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What would the ideal disinfectant have?
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Compatibility with surfaces
Cleaning as well as disinfecting properties Low allergenicity Ease of use Clear, easy-to-follow instruction Reasonable contact time Acceptable storage and disposal requirements Reasonable use life and shelf life |
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What website includes everything you want to know about infection control in dentistry?
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OSAP (osap.org)
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What is a high level disinfectant?
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Destroys or inactivates almost all microbial life (but not spores)
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What is the contact time required for high-level disinfectants?
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3-10 hours
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What are high level disinfectants also known as?
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Chemical sterilants
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What are high level disinfectants typically used for?
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Heat-sensitive critical and semi-critical items (endoscopes, etc)
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What is an intermediate-level disinfectant?
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Destroys mycobacterium TB, viruses, fungi and begetative bacteria
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What are intermediate-level disinfectants used for?
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Used for disinfecting dental operatory surfaces
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What is "hospital" disinfectant?
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Effective against Staph aureus, Salmonella, Pseudomonas, TB
Generally intermediate level disinfectant |
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What is a tuberculocidal?
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inactivates mycobacterium tuberculosis
Generally intermediate level disinfectant |
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What are the different types of surface disinfectants?
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Alcohol
Phenols Iodophors Bleach |
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Is alcohol acceptable for instruments or surfaces? Why or why not?
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Alcohol is unacceptable for instruments or surfaces
Evaporates rapidly Doesn't kill sports Doesn't work in presence of blood and saliva |
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What type of disinfectant is phenol?
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Tuberculocidal
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What are the downfalls of phenols as a surface disinfectant?
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May irritate skin
Can corrode metal |
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What type of surface disinfectant do we use at UMKC?
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Phenols
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What type of disinfectant are iodophors?
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Tuberculocidal (broad antimicrobial action)
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What are the pitfalls of using iodophors?
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stain surfaces
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What are the advantages of using iodophors?
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Low irritation
Residual effect after surface is dry |
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What are the advantages to using bleach?
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Inexpensive
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What are the disadvantages to using bleach?
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Corrosive
Caustic to skin Unpleasant odor |
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What do low level disinfectants kill?
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Some viruses and fungi
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Where can low level disinfectants be used in a dental office?
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Floors
Walls General Housekeeping |
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What are the steps in development of infection?
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Source (infected individual)--->
Escape of microbes from source---> Spread of microbe to new person ---> Entry of microbe into person ---> Infection (survival and growth)---> Damage |
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What are the requirements for development of an infection?
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Susceptible host
Pathogen (in sufficient numbers) Portal of entry |
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What are the modes of transmission of infection?
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Direct (broken skin, mucosal contact)
Indirect (contaminated instruments, surface) Droplet (sneezing, coughing) Inhalation (suspended microorganisms) |
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What is the most common mode of transmission of infection in dentistry?
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Inhalation
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What does 'cough etiquette' include?
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Cover the nose/mouth when coughing or sneezing
Use tissues to contain respiratory secretions Dispose of tissues in "no-touch" receptacle if possible Wash hands afterwards Wear a mask if infectious Sneeze into antecubital area (if wearing long sleeves) |
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What are the stages of an Infectious Disease?
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Incubation (initial entrance to first symptoms)
Prodromal (appearance of early symptoms) Acut (greatest amount of symptoms) Convalescent (recovery) |
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What are the causes of disease emergence?
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Microbial changes
Breakdown in public health measure Ecological changes Changes in human demographics/behaviors International travel and commerce |
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What does bacteriostatic mean?
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Inhibition of growth of microorganisms
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What does bacteriocidal mean
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Killing the microorganisms
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How are microorganisms removed from the environment?
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Filtration
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What is a vaccination?
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administering a killed or weakened form of a disease-causing organism to patients to prevent a more serious form of the disease
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What are some vaccine preventable diseases?
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Anthrax
Cervical Cancer Diphtheria Hepatitis A and B Haemophiles influenzae type B (Hib) Influenza Japanese Encephalitis Measles Meningitis Mumps Pertussis (whooping cough) Pneumococcal disease Polio rotavirus Rubela (German Measles) Herpes Zoster (Shingles) Tetanus (lockjaw) Typhoid fever Varicella (chickenpox) Yellow fever |
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What is an anaphylactic reaction?
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Hypersensitivity resulting from sensitization following prior contact with the causative agent
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Can a person have an anaphylactic reaction the first time they are exposed to a substance?
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No
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What is immunoprophylaxis?
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Preventing the spread of disease by providing supplemental antibodies AFTER exposure
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What is an example of immunoprophylaxis?
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Hepatitis B immune globulin
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Who are Category A vaccines recommended for?
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All dental health care professionals
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What are category A vaccines?
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Hepatitis B
Influenza (yearly in fall) Measles Mumps Rubella Varicella (chicken pox) |
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What vaccines does UMKCSOD require for entry to school?
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2 doses of measles/mumps/rubella
HBV TB test |
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Do you need to be tested for immunity to HBV before vaccination and is a booster needed?
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No
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Who are Category B vaccines recommended for?
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People under certain circumstances
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What are Category B vaccines?
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TB
Hepatits A Meningitis Pertussis (whooping cough) Typhoid Vaccinia (smallpox) |
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What vaccine was once only given to children but now is safe for adults?
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Pertussis
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Is there evidence that dental procedures generate droplet nuclei containing TB?
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no
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Who are Category C vaccines recommended for?
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All adults
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What are Category C vaccines?
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Tetanus (booster on the '5's)
Diphtheria Pneumococcal disease (for certain populations) |
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What does OSHA stand for?
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Occupational Safety and Health Administration
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What is the purpose of OSHA?
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Protect employees
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Who runs OSHA? Why is this a good setup?
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federal or state run
This is a good setup because OSHA has the force of law behind it |
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What are the three types of OSHA regulations?
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Administrative controls (policies to reduce risk of occupational exposure)
Engineering controls (devices used to isolate risk of exposure) Work Practice controls (procedures to reduce likelihood of exposure) |
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What two materials is OSHA concerned with?
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Blood
Other potentially infectious materials (OPIM) |
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What are OPIM?
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Other potentially infectious materials, including:
Semen Vaginal secretions Cerebrospinal fluid Synovial fluid Pleural fluid Peritoneal fluid Amniotic fluid Saliva in dental procedures (IMPORTANT) any body fluid visibly contaminated with blood All body fluids if you can't differentiate what it is Any unfixed human tissue or organ |
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What is PPE?
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Specialized clothing or equipment for protection against a hazard
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When should PPE be removed?
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When leaving treatment area
When visibly compromised |
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What are the four types of PPE?
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Gown
Mask Glasses (with side shields) Gloves |
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When should gowns be worn?
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Anytime saliva or aerosols generated
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When should the mask be changed?
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Changing patients
Mask becomes damaged Mask becomes damp Every hour if heavy aerosol |
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What should glasses be cleaned?
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Between patients
When soiled |
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Can face shields be used in place of a mask?
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Not at UMKC
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When should a gown be changed?
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Visibly soiled
Torn Before leaving clinic |
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Do gloves protect the DHCW from the patient or the patient from the DHCW?
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Both
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Are gloves a substitute for handwashing?
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No
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Are surgical gloves sterile or non-sterile? What about exam gloves and utility gloves?
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Surgical gloves are sterile
Exam gloves and utility gloves are non-sterile |
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What are glove alternatives to latex gloves?
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Vinyl
Nitrile Low-protein rubber latex Guayule |
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When should gloves be used
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whenever contact with blood, saliva or mucous membranes is possible
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When should gloves be changed
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Between patients
When soiled or torn |
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Do you need to wash your hands before or after donning gloves?
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Yes, both
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Can gloves be worn when handling paper charts?
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No
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What is considered regulated waste by OSHA?
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Blood or OPIN in liquid or semi-liquid state
Items caked with dried blood or OPIM that may release it Contaminated sharps Pathological or microbiological waste that contains blood or OPIM |
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What is the exposure control plan?
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The exposure control plan is a written plan to eliminate or minimize exposure and must be accessible to all employees.
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When must the exposure control plan be updated?
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Annually or when procedures, employees, or technology changes
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What is the MSDS scale for hazardous materials?
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0-4 (4 being the most hazardous)
Blue = health hazard Red = fire hazard Yellow = reactivity hazard White = other hazard |
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What are the CDC guidelines and are they backed by law?
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a standard of care
They are not backed by law |
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What are the CDC guidelines intended to prevent
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Transmission PT to DHCP, DHCP to pt, pt to pt
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What is the most common type of transmission of disease?
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Pt to DHCP
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What are "standard" precautions?
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We treat everyone as though they are infectious
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What are the CDC guidelines concerned with?
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Blood
Other body Fluids Secretions Saliva Excretions (except sweat) Non-intact skin Wounds Mucous membrane exposure (oral, nasal) |
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What is the best way to prevent pathogen transmission?
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Hand Hygiene
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What is the best handwashing technique?
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Wet hands first
Apply foam Rub fingers and thumb Scrub for 15 seconds Rinse and dry completely |
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What is the best type of soap to use when performing surgical procedures?
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Antimicrobial soap
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What type of soap may not be used for surgical procedures?
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Regular soap (not antimicrobial)
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When can an alcohol rub be used?
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When the hands are not visibly soiled
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What type of lotion should not be used before donning gloves?
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Petroleum based lotion
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What gets in the way of hand hygiene?
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Artificial or long fingernails
Large rings |
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When should you wash your hands
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When visibly dirty
After touching contaminated orbjects Before and after patient treatment (before and after gloving) |
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What are the advantages to alcohol based hand products?
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Rapid, effective antimicrobial action
Improved skin condition More accessible than sinks |
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What are the disadvantages to alcohol based hand products?
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Cannot be used if hands visibly soiled
Must be stored away from high temperatures or flames Hand softeners and glove powders may "build up" |
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What is a latex allergy and what are some reactions that may occur?
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Type I hypersensitivity to natural rubber latex proteins
Reactions: nose, eye and skin reactions (or more seriously respiratory distress- rarely shock or death) |
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What is contact dermatitis?
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Not an allergy
Dry, itchy, irritated areas |
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What is an allergic contact dermatitis?
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Type IV delayed hypersensitivity
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Are latex allergies increasing or decreasing among dentists?
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Decreasing
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In what order should PPE be donned?
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Outerwear
Mask Eyewear Wash Gloves |
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What are the symptoms of Staph Aureus, where does it occur, how it it transmitted and what is the best defense?
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Symptoms: pustules or boils, red, swollen, painful or draining
Occurs at: cuts, abrasions or hairy sites Transmission: towels, razors, used bandages, workout equipment Best defense: hand hygiene, bandage all cutes, keep common surfaces clean |
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What direction are bloodborne pathogens most likely to be transmitted?
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pt to DHCP
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How is the risk of pathogen transmission determined?
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Amount of bugs
Route of exposure Susceptibility of recipient Frequency of infection among patients Type of virus Type and frequency of blood contact |
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How long can Hepatitis B survive in blood?
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up to 1 week
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What percentage of HBV patients are chronic carriers?
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10%
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What percentage of the population is infected with HBV?
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1%
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When was the last documented case of HBV?
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1987- pt --> DHCP
2003- pt --> pt |
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Is hepatitis C transmitted by blood exposure?
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HCV not transmitted efficiently by occupational blood exposure
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What is the occurance of HCV is US dentist? The general population?
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1-2% in both
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How is hepatitis C transmitted?
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needlesticks (especially hollow-bore)
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How many reports of HCV transmission have there been in a dental setting?
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0
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When does HDV occur?
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Only with HBV
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What percentage of HBV+ patients have HDV? What does the combination result in?
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4%
Results in higher mortality |
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How long can HIV survive in air?
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seconds
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What is the risk of transmission of HIV?
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Very low
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What is the risk of HIV transmission with:
Single needlestick Mucous membrane exposure Intact skin exposure |
Single needlestick: .3-.5%
Mucous membrane exposure: .1% Intact skin exposure: <<.1% |
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Can patients with tuberculosis be treated with dental procedures?
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These patients are usually too sick, and non-emergent procedures should be postponed
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What is the UMKC Bloodborne Pathogen Policy?
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must know your own health status (specifically of HBV, HCV, and HIV) and report positive tests to the Chair of Infection Control Committee
Refrain from clinical activity until decision is made by committee |
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What diseases, when actively infected, result in a restriction on work?
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Diptheria
Hep A Hep B Measles Mumps Pertussis Rubella Varicella Meningococcus |
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Does a pre-procedural mouth rinse help prevent disease?
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No scientific evidence of disease prevention, but does decrease oral microbes
Most beneficial in cleaning |
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What are the needlestick protocol at UMKC?
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Wash with soap and water
Do not use surface disinfectant Call Dana Linville or Dr. Eplee Fill out paperwork Ask patient for blood sample (oral surgery) Take to Truman Medical Center |
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What increases the risk of HIV transmission?
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Deep injury
Visible blood Needle in artery or vein Terminal illness if source patient |
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What controls decrease the risk of HIV transmission?
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Puncture resistant sharp containers
One-handed scoop recapping |
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What is the average risk of bloodborne virus transmission after needlestick for:
Hep B Hep C HIV |
Hep B: 1-31%
Hep C: 0-7.0% HIV: 0.3-0.5% (KNOW THIS) |
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What are the postexpsoure protocol for HIV?
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Needlestick: soap and water
Mucosal splash: water Report and fill out paperwork promptly Antiretroviral drugs |
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What are considered clinical contact surfaces and how should they be treated?
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Light handles, computers, countertops, pens
Plastic wrap or high level disinfection |
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How should extracted teeth be treated if they are being:
disposed of sent to the lab given to patient save for preclinical lab |
dispose into medical waste container
sent to lab: intermediate level disinfect given to patient: no regulation saved for lab: clean gross debris, put in 1:10 bleach, Biohazard label, autoclave if no amalgam (formalin for 2 weeks if amalgam) |
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What is the risk level of the mercury component of amalgam fillings?
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moderate
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What is biofilm?
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slime layer formed by bacteria
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How does laminar flow contribute to biofilms?
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flow near biofilms ~0
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How many colony forming units are found in city water?
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500 CFUs/mL
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What is the ADA standard for CFUs?
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As low as reasonably achievable (Max 500 CFUs/mL)
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What is a waterline flush?
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Running water from air-water syringe, handpiece line, handpiece and cavitron line
2 minutes at start of day 20-30 seconds between patients |
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What are the waterline treatment options?
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Antiretraction valves
Coated tubing (halamines) Separate water lines Filtration Ozination |
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What does UMKC use to clean its water lines?
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Stericil (silver ions)
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What should be done when a boil water advisory is issued?
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Stop using units
Flush lines 1-5 minutes Disinfect waterlines |
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How do ultrasonic cleaners work?
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Use high frequency sound waves and cavitation to loosen and remove debris
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How effective are ultrasonic cleaners compared to hand scrubbing?
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16 times more effective
Also, less potential to injure self with instrument |
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How should handpieces be cleaned?
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Sterilize
Flush for 20-30 seconds before use |
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How should metal instruments be cleaned?
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Sterilize
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Can disposables be reused?
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No
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What type of air-water syringes do we use? (What are they made of)
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Metal
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Should the patient close their lips around the saliva ejector?
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No
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What instruments are found in a basic oral exam tray?
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Mirror
Double-ended explorer Periodontal probe Air/water syringe tip |
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What are the instrument sterilization options and which do we use?
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Steam autoclave (we use, most common)
Dry heat Chemical vapor Ethylene oxide Chemicals |
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What are the disadvantages of an autoclave?
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Dulls cutting edges
Rusts |
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What are flash sterilizers?
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Autoclave with higher temperature and/or pressure
used for handpieces Not intended to be used as sole or primary method of sterilization |
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What are the advantages and disadvantages of dry heat?
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Advantages: doesn't dull cutting edges, won't rust
Disadvantages: long cycle, handpieces won't tolerate, poor penetration |
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What is a chemiclave?
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Steam under pressure with chemical vapor
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What are the advantages and disadvantages of a chemiclave?
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Advantages: shorter cycle
Disadvantages: chemical vapor hazardous |
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What is spore testing and how does it work?
How often does Missouri require this? |
Biological monitoring using non-pathological spores on paper strips
Vial sterilized in autoclave and analyzed to see if the spores were killed Required once per week in Missouri |
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How long do gluteraldehydes take to sterilize instruments? to disinfect instruments?
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6-10 hours to sterilize
20-30 minutes to disinfect |
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What are the disadvantages to gluteraldehydes?
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May corrode instruments
Toxic and irritating Instruments must be rinsed afterward Must store in sterile container |
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What are Quaternary Ammonium compounds and do they sterilize instruments?
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DO NOT STERILIZE
Mild antimicrobial activity ADA recommends these not be used in dentistry |
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What are the 2 steps to preparing a cubicle and what PPE needs to be worn?
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Clean, then disinfect
Gloves should be worn |
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What is the objective or cubicle cleaning?
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Disinfection (destruction of pathogenic microorganisms)
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What disinfect the cubicle?
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Wide variety of infectious diseases (Hep B alive for 3-5 days on surface)
Patients not always forthcoming about infection status Use of aerosols Open wounds in patient's mouth |
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What disinfectant is used at UMKC for cubicle cleaning?
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Pro-phenol Plus
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What should be done before each patient (in terms of cubical cleaning)
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Spray- wipe- spray
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Where can surface disinfectants be used?
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Hard non-porous surfaces, such as:
Countertops Sink Mobile cart Patient chair Doctor and assistant chairs NOT on delivery arm NOT on light (these are plastic wrapped) |
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What needs to be plastic wrapped in cubicle prep?
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Computer keyboard (use bag for mouse)
Delivery tray Chair controls Light |
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How is a cubicle broken down?
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Start with top of cart (wearing gloves)
Use headrest cover bag to dispose of materials Put instruments back into cassette, put cassette into headrest bag, take to CSR Take off gloves after handing over and put into red biohaz bag |
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When is something considered infectious waste?
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If it is "squeezable or dripping"
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Where do gowns go after they are used?
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Red cavas laundry bag
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What instruments should you take special care with?
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Sharps
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What is an impression?
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negative recording of tissues
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What is alginate?
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Irreversible hydrocolloid (what we take impressions with)
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What is a cast?
|
Positive model frabricated from impression
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What materials are needed for impressions?
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Alginate impression material (canister, water measure, powder scoop)
Impression trays Red rope wax rubber mixing bowl wide blade spatula |
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What materials are needed for making the cast?
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Plaster knife
Lab knife Plastic Resin sheets Rubber mixing Bowl Metal mixing spatula |
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What are the factors for selecting a tray?
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Adequate coverage (includes all teeth)
Patient comfort |
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What is red rope wax used for?
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Border for additional height
Palate for high vaults |
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What are tori?
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Small bony bumps on inside of mandibular arch
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Can alginate be thrown down the sink?
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NO
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How many scoops/lines are used for mandibular impressions? maxillary impressions?
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Mandibular- 2
Maxillary 3 |
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How can setting be slowed?
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Use cold water
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How can you avoid incorporating air bubbles in the impression material?
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Wipe the material against the side of the tray then spread it
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How should the tray be seated in the mouth for impressions?
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Retract cheek on one side
Slide in tray side first Retract opposite cheek and rotate tray above arch Hold out lower lip Seat tray (posterior first) Be sure to use even pressure on both sides |
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How should the tray be removed after impressions?
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Place finger under rim of tray
Break seal Protect opposing arch Life quickly ("snap") Retract cheek Remove tray Check for voids and air bubbles |
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How should impressions be stored?
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Rinse with water
Shake to remove excess water Spray with surface disinfectant (Pro-Phenol) Wrap in damp paper towel Bag in headrest cover Pour cast within 15 minutes (ASAP) |
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Where should alginate material be disposed?
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Into the trashcan
NOT THE SINK |
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Where should you stand when taking a mandibular impression? Maxillary?
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Mandibular- in front of the patient
Maxillary- behind the patient Keep arms below heart |
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When pouring the cast, what is the ratio of water to stone?
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28 mL water to 100 g YELLOW stone
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When should the impression be removed from the cast?
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Once it has gotten warm then cooled
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How should the tray be removed from the cast?
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Gradually, not like the snap when the impression was removed
Work all the way around with a buffalo knife Remove tray in line with the teeth |
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Which surface should be trimmed first on the model?
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The base should be trimmed parallel to the occlusal plane first
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How should the backs of the casts be trimmed?
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Together! Without hitting any posterior teeth
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How should models be finished?
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Remove bubbles
Fill defects Buff with a soft toothbrush |
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What is a normal oral temperature?
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Anywhere between 96 and 100 F
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When is temperature lowest and highest?
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Lowest on rising, highest in later afternoon
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Where can pulses be found?
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Radial
Brachial Carotid Femoral |
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Where is the radial pulse?
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Thumb side, inside of the wrist
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How long are pulses generally taken for?
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20 seconds (then multiply by 3)
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What is a normal pulse?
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60-90 bpm
Children higher Athletes lower |
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What is an arrhythmia?
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Irregular rhythm
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What is Fremitus?
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Vibration accompanying a murmur when taking pulse
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What is a thrill?
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Turbulence so marked that it is palpable
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What is PMI
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Point of maximal impulse
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What is a "water-hammer" pulse?
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Forcible impulse but immediate collapse
sign of aortic incompetency |
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What are gallops?
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Triple cadence at beats > 100
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What are friction rubs?
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Sound like squeaky shoes
Sign of pericarditis |
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What is a bruit?
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Abnormal ausculatory sound
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What is a carotid bruit?
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hear whooshing at carotid artery
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What is a normal respiration rate?
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12-20 breaths/minute
Children higher Athletes lower |
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What is bradypnea?
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Slow breathing
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What is tachypnea?
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Rapid breathing
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What is apneustic?
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post-inspiratory pause (abnormal)
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What is systolic pressure?
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Pressure at max contraction
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What is diastolic pressure?
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Pressure at max relaxation
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What is pulse pressure?
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systolic- diastolic
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Where is the antecubital fossa?
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Inside of the elbow
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When should you not use an arm to take blood pressure?
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If you see a wound, scar or bandage in the area
If they have a history of lymphedema (result of a past mastectomy) |
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Which way should the stethoscope tips point?
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Into the ears (forward, away from you)
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What should the cuff be pumped up to when taking blood pressure?
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160-200
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What are heart sounds called?
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Korotkoff sounds
First is systolic Second is diastolic |
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How long should you wait before retaking a blood pressure?
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2 minutes
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What are normal blood pressures?
|
Systolic: 100-140
Diastolic: 60-90 |
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What are the blood pressure levels for a medical consult, no surgical procedures and emergency treatment only?
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Medical consult: 140/90-160/100
No surgical procedures: 160/100-180/110 Emergency Treatment only: >180/110 |
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What factors increase or decrease blood pressure?
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Increase:
Stress 6-12 mmHg Caffeine: 10-14 mmHg Tobacco: 8-10 mmHg Cocaine/amphetamines White coat effect Decrease: Heavy exercise: 20 mmHg Big meal: 20 mmHg |
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What flow rate of oxygen should be used?
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6-8 L/min
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At what level is the tank considered to be 'depleted'?
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<500 lbs pressure
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What is the emergency phone number to be used during clinic hours?
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4444
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What is the emergency phone number to be used after clinic hours in the building?
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1515 (security)
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What should you do if your patient is having a Code blue?
|
Stay with the patient
Ask a nearby student or faculty to get oxygen/call Code Blue team if appropriate |
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What is syncope?
|
fainting
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What are signs of syncope?
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Pallor
Light-headedness Increased perspiration Loss of consciousness |
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What are some causes of syncope?
|
Decrease in blood supply to brain
Shock from seeing instruments, needle, blood Internal stimuli such as pain, hunger or fatigue |
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What should be done in a patient faints?
|
Recline patient
Adjust headrest to ensure open airway Loosen right clothing Check pulse Apply cold damp towel to forehead Administer oxygen if necessary |
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What is the treatment for hemorrhage?
|
Apply sterile gauze pack to the area and tell patient to bite on it
Check socket in 5-10 minutes Replace gauze if saturated with blood Continue for at least 30 minutes or until bleeding stops |
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Points to remember during an emergency
|
Be aware of facial expressions- yours as well as the patient's
Listen to your patients Be reassuring and calm Determine the cause of the problem Take appropriate action |
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What is the name UMKC uses for a cardiopulmonary emergency?
|
Code Blue
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When should instruments be opened?
|
In front of patient
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What is needed for the patient in cubical prep?
|
Patient bib
Napkin chain Glasses |
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Who is in charge of recognizing the patient's needs?
|
The assistant
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What zone will the assistant be in for a right handed operator? A left handed operator?
|
Right handed: 2-5
Left handed: 8-11 |
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What is the operator's position?
|
Feet flat on the floor
Thighs parallel to floor Body weight centered on chair Patient lowered until mouth is below operator's head level |
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What patient position should we strive for?
|
Semisupine (nose slightly higher than knees)
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What is semi-supine position?
|
patient's nose slightly higher than knees
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What is supine position?
|
patient's nose and knees on same plane
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What is subsupine?
|
patient's head lower than feet
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What is Trendelenburg?
|
patient's head WAY lower than feet (DO NOT USE)
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What is modified Trendelenburg?
|
patient's legs are elevated
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How high is the assistant's chair?
|
2-6 feet above dentist's chair
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What causes musculoskeletal disorders?
|
repetitive motion
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What are some MSD causes in dentistry?
|
Posture (leaning)
Motion Bending and twisting Repetitive motion Equipment (vibration, ill-fitting gloves) |
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What are some ways to prevent MSD?
|
Magnification (loops)
Position patient correctly Forearms parallel to floor Position yourself correctly Lumbar support Don't rest elbows on belly bar on assistant's chair (cuts off circulation) Stretch breaks Aerobic exercise Instruments: cushioned or textured grip Large handle Wrist support |
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What areas are most affected by MSDs in women? men?
|
Women: shoulder and neck
Men: mid to lower back |
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Where should instrument exchange take place?
|
Over the patient's chest/abdomen (NOT face)
|
|
|
What is the most commonly used instrument grasp?
|
Modified pen
|
|
|
How should an instrument be delivered to the operator?
|
Into working position
|
|
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How should an instrument be taken from the operator when performing an instrument transfer?
|
Use little finger to grasp old instrument
|
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|
How is a syringe assembled?
|
Retract plunger
Remove clear plastic needle cover Twist plastic needle onto syringe Engage plunger Hold syringe firmly in one hand (plunger up) Use palm of other hand to deliver a single sharp tap to engage harpoon into rubber stopper in anesthetic carpule |
|
|
Where should the syringe be transferred?
|
Behind the patient's head
|
|
|
How should a syringe be recapped?
|
One handed scoop method
or Hemostats |
|
|
Where should the saliva ejector be placed?
|
The 'downhill' side
If using a rubber dam, under the dam |
|
|
What does the high speed evacuation do?
|
Removes spray coolant from high speed handpiece
|
|
|
Where should the high speed evacuation tip be placed?
|
~1 tooth behind the working tooth
Avoid bumping teeth, lips, or gingival Position AFTER operator positions handpiece Bevel tip parallel to buccal or lingual surface Middle of tip even with occlusal surface |
