Behavior management issues for pediatric patients
Article Abstract:
Children can present special psychological and physical problems for dentists, who may need to develop skills for treating them. Standards set out in the American Academy of Pediatric Dentistry for pediatric dental patients include recommendations for: communicative management, conscious sedation, general anesthesia, hand-over-mouth technique, nitrous oxide-oxygen inhalation sedation and physical restraint. Communicative management involves techniques such as voice control, distraction, positive reinforcement, tell-show-do technique, and nonverbal communication. While these approaches may seem to reflect aspects of general communication, parents may have firm ideas regarding how the dentist should talk to the child. Negative comments should be directed at children's behavior, not at the children themselves. Dentists should be skilled in the use of any drugs they may use for conscious sedation. Behavior management is preferable to conscious sedation; if the former cannot be carried out, it may be advisable to skip the treatment. If sedation must be used, a consent form should be completed by the parent and careful records of the treatment should be kept. The required personnel should be present (people trained in cardiopulmonary resuscitation) and emergency equipment must be at hand. Proper training in operating room protocol is essential before general anesthetics are used. The hand-over-mouth technique can encourage communication, but it requires parental consent. Nitrous oxide also requires consent and, again, records of the treatment dose should be kept. Commercially available physical restraints can be used. It is absolutely essential to obtain informed parental consent when using these methods. Parents should understand what is proposed and what any risks are. If dentists do not obtain this consent, they may be exposed to civil and criminal liability. Some dental practitioners specialize in pediatric care and difficult cases should be referred to them. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of the American Dental Association
Subject: Health
ISSN: 0002-8177
Year: 1991
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Disclosing adverse events: You said it, now write it
Article Abstract:
The Joint Commission on Accreditation of Healthcare Organizations instituted a requirement in 2001 that hospitalized patients and their families be told of unanticipated outcomes. Guidelines giving information as to when to disclose an adverse event, how to document it, and how to identify the right time for documenting it, are presented.
Publication Name: Nursing Management
Subject: Health
ISSN: 0744-6314
Year: 2006
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