Conscious sedation during the return to clinical practice
Posted 28 July 2020
When re-starting dental conscious sedation as the resumption of clinical practice resumes, SAAD would encourage sedation teams to review the following and undertake their own risk assessment as they re-introduce conscious sedation to support the delivery of dental care.
The following statements are offered as considerations to aid decision-making for each unique clinical environment:
- Review and / or redesign the patient journey to ensure safety of patients, their escorts and the dental team.
- Patient assessment – the possible use of technology for remote assessment including COVID status with a clear understanding by the patient that, in the absence of a separate assessment appointment, sedation may not be provided if assessment on the day precludes safe care.
- Pre-appointment process – reconfirm COVID status, electronic payment arrangements.
- Patient arrival – process to confirm identity / details of patient and escort. Establishment of one-way systems throughout practice.
- The development of operating capacity by initially undertaking simple cases.
- Treatment session – all necessary equipment is to hand, and the correct PPE worn depending on the anticipated type of clinical procedures to be undertaken.
- Sedation teams to carry out individualized risk assessments based on the team, the environment, the types of patient to be treated and the procedures to be delivered; such information will inform content of Standard Operating Procedures.
- Potential for clinical care as an AGP’s and / or AGE.
- Escort arrangements – preferably member from same household or bubble and the escort’s COVID status determined.
- Recovery – area / location to be used for this phase. Type of PPE to be worn in recovery area.
- Place for escort to wait whilst patient treatment carried out – consider off-site and request, (telephone / text), escort to return when patient recovered.
- Discharge process, use of one-way system to exit premises.
This guidance list is not exhaustive and is not intended to be prescriptive.
Restarting IV Sedation in the clinical environment
Posted 8 July 2020
Further to the recent re-opening of dental practices SAAD has received enquiries from members related to the re-commencement of intra-venous sedation.
Sedation is an excellent adjunct as you are restarting your practice. You should consider using it because it is safe to do so in line with SOPs and cross infection policies.
SAAD recommends that risk assessments are undertaken and robust Standard Operating Procedures are designed that consider the management of the patient, escort, the staff and the environment in which the IV sedation is to be delivered.
Several guidance documents related to the implications of the COVID-19 virus and the delivery of dental care have been published which members may wish to consider.
Inhalation Sedation and Aerosol Generating Procedures (AGP’s)
Posted 5 June 2020
The recent document from the Office of the Chief Dental Officer, (OCDO), ‘Standard operating procedure Transition to recovery’, states that Inhalation Sedation is not considered an AGP and may be a suitable alternative to general anaesthesia for children needing dental care.
This document also provides guidance on the appropriate PPE to be used in the dental setting and also states, ‘As SARS CoV-2 is a novel virus, evidence is still emerging so further updates to this Appendix may be made as new evidence emerges’.