10115966
Description
Flashcards by Brianne Schmiegelow, updated more than 1 year ago
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Created by Brianne Schmiegelow
over 6 years ago
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| Question | Answer |
| What is the emergency phone number? | 4444 |
| Order of PPE | 1. Gown 2. Glasses 3. Mask 4. Gloves |
| When do you have to wash your hands? | -After using bathroom - Before eating - Before and after degloving - Dry hands completely |
| Rules of oral surgery | Don't lock your knees Don't touch anything with your gloves Keep your hands above the waist |
| What position is patient in? | semi-supine |
| Usual sequence for positioning | Operator Patient Light Assistant |
| How to establish your preferred position | 1. Sit in operator's chair with seat angled forward 2. Close eyes 3. Relax muscles 4. Sit in free space not leaning on backrest 5. Adjust height of the stool so thighs are slightly downhill 6. move upperbody to comfortable position 7. Move head to comfortable position 8. Bring thumbs and index fingers together 9. Open eyes and remember! |
| Where should your patient be? | Mouth should be at heart height in mid-saggital plane |
| When do you not want wide open mouth? | When looking at buccal surfaces of posterior teeth |
| How should assistant's chairs be positioned? | - 2-6" above dentist's chair - Find a place to rest your forearm - work area should be below the elbow - Instruments should be close at hand |
| What are some features of an assistant chair? | - Taller than dentist's chair - Foot ring - Abdominal support - Seat up-down adjustment |
| What are the zones of operation? | Static (12-2; instrument cart, etc.) Assistant (2-4) Transfer (4-7) Operator (7-12) ***reverse this for L-handed operator |
| Causes of MSD in dentistry | Posture (leaning) Bending and twisting Repetitive motion Equipment (vibration, ill-fitting gloves) |
| How can we prevent MSD? | Magnification Position the patient correctly (forearms parallel to the floor) Position yourself correctly Stretch breaks Aerobic exercise Instruments with cushioned grip and large handle Wrist support |
| Where do women get MSD most often? Men? | Women: shoulder and neck Men: mid to lower back |
| Where do you exchange instruments? | Only in the transfer zone! |
| How do you position the working end of the instrument correctly? | Maxillary: UP Mandibular: DOWN |
| Where do you put anesthetic syringes? | Have them ready to go but hidden from view Usually under patient napkin |
| Steps of syringe assembly | 1. Insert carpule into syringe 2. Remove clear plastic needle cover 3. Twist plastic needle onto syringe 4. Engage plunger (hold syringe firmly, plunger up, and use palm of other hand to deliver a single sharp tap) |
| Which fingers do you use as fulcrums? | 3rd and 4th fingers |
| What does high-speed evacuation do? | Removes spray coolant from the high-speed handpiece |
| Oral evacuation tip placement | Position after operator positions handpiece Avoid bumping the teeth, lips, or gingiva Rest on tooth distal to target tooth Bevel of tip should be parallel to the buccal or lingual surface Middle of tip should be even with the occlusal surface Far enough from handpiece that it doesn't draw off water spray |
| #17 (Cowhorn) explorer |
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| EXT 11-12 explorer ("pigtail") |
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| DE #17 explorer/calculus detection |
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Svedopter Saliva ejector + tongue guard |
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Cavitron tip |
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Elevator (oral surgery) |
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Bard-Parker (scalpel) handle |
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Articulating paper holder |
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Cement spatula |
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Plastic instrument |
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Round burs |
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Inverted cone burs |
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Straight fissure burs |
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Finishing and tapered fissure burs |
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Small spoon excavator |
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Large spoon excavator |
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matrix bands |
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Amalgam capsules Double (blue) Single (green) |
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amalgam carrier |
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small amalgam carrier |
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large amalgam carrier |
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Discoid/Cleoid carver |
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Hollenbeck carver |
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Ball burnisher |
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Appleseed burnisher |
| Average oral temperature | 98.2 |
| When are the lowest and highest times of body temperature? | Lowest at 6AM and highest 4-6PM |
| UMKC SOD normal temperature | 97-99 degrees |
| How to convert from axillary/rectal temperature | Axillary = oral - 1 Rectal = oral + 1 |
| How do you measure oral temperature? | Under tongue, as far back as comfortable 20 minutes since patient had anything to eat or drink Wait for the beep |
| Where do we measure pulse? | Radial, brachial, and carotid Take for 20s and multiply by 3 |
| What is normal pulse? | 60-90 bpm Kids higher, athletes lower |
| What is arrhythmia? | Irregular heart rhythm |
| What is fremitus? | Vibration accompanying a heart murmur |
| What is thrill? | Turbulence so marked that it is palpable |
| What is PMI? | Point of maximal impulse |
| What is water-hammer pulse? | Forcible impulse but immediate collapse aortic incompetency |
| What causes "squeaky shoe" sound in heart? | Pericarditis |
| What is "gallops" in heart? | Triple cadence at beats >100 Due to abnormal 3rd or 4th heart sound Usually indicates serious disease |
| What is bruit? | An abnormal auscultatory sound |
| What is carotid bruit? | Systolic murmur heard at the root of the neck but not at the aortic area OR any bruit produced by blood flow in the carotid artery |
| What is normal breaths per minute? | 12-20 bpm |
| What is bradypnea? Tachypnea? | slow breathing (B) fast breathing (T) |
| What is apneustic breathing? | post-inspiratory pause ABNORMAL |
| What is the antecubital fossa? | triangular area on anterior view of elbow |
| What exceptions are there for where we take blood pressure readings? | Wound, scar, or bandage Lymphedema from mastectomy |
| How long should you wait before retaking BP? | >2 minutes or confirm on other arm |
| What is a normal BP reading? | Systolic 100-140 Diastolic 60-90 |
| What is hypotension? | Generally <90/<60 Notify patient Sit them up slowly to prevent orthostatic hypotension (?) |
| What is hypertension? | 140/90 - 160/100: med consult 160/100 - 180/110: no surgical procedures >180/110: emergency treatment only Notify patient and faculty in any case |
| Common mistakes when taking blood pressure | Rushing Cuff size Cuff fit Arm not at heart level or not supported |
| Hypertension patient factors | Stress (increases BP by 6-12 but goes away after 5-10 minutes) Distended bowel or bladder Hypertension and drugs Caffeine (if not a habitual drinker) Tobacco (lasts for 30 minutes) Cocaine Amphetamines Meth |
| Fire extinguisher locations | Dispensary CSR Fire hoses Special Patient Care (2) Second floor labs Library (2) Oral surgery (2) |
| First aid kit locations | 1st floor lab 2nd floor labs (both sides) |
| Exposure Control Plan (OSHA) | Must be accessible to all employees Must be reviewed or updated annually when: - You change procedures - You have new classes of employees that are exposed - Relevant technology changes Document annual consideration and implementation of new safer devices |
| What is on a Safety Data Sheet? | Properties of each chemical The physical, health, and environmental health hazards Protective measures Safety precautions for handling, storing, and transporting the chemical |
| What are Safety Data Sheets meant for? | Employees who may be occupationally exposed at work Employees who need to know the proper methods for storage etc. Emergency responders such as fire fighters, hazardous material crews, EMTs, and emergency room personnel |
| Safety Data Sheet locations | Dispensary All labs |
| Safety Data Sheet diamond risk label scale | 0-4 (4 most severe) Blue = health hazard Red = fire hazard Yellow = reactivity hazard White = other hazards |
| RE-READ AMALGAM SAFETY DO'S AND DONT'S | :) |
| What are the amalgam categories? | Non-contact amalgam (scrap) is excess mix leftover at the end of a dental procedure Contact amalgam has been in contact with the patient - Includes extracted teeth with amalgam restoration, carving scrap collected at chairside, and amalgam captured by chair side traps, filters, or screens (amalgam "sludge") |
| What is syncope? | Fainting |
| What are the signs and treatment of fainting? | Pale, cold, clammy skin, dizziness Recline the patient, adjust headrest, ensure an open airway, loosen tight clothing, check pulse, apply cold damp towel to forehead, administer oxygen (only if necessary) |
| How do you open the main tank valve of an oxygen tank? | R = tight L = loose |
| What should the oxygen tank flow be? | 6-8 liters/min average adult |
| What should pressure of oxygen tank be? | >500 lbs if less than that, take tank to dispensary for replacement |
| What should you do if patient is bleeding? | Apply pressure with sterile gauze, instruct patient to bite on it, and wait 5-10 min If gauze is saturated, apply new gauze Continue this procedure for at least 30 minutes or until bleeding stops |
| What do you call during medical emergency? | 4444 during business hours 1515 after hours (816-235-1515) 911 outside building and on weekends |
| What is considered Regulated Medical Waste? Where does it go? | Gauze saturated with blood after surgery Extracted teeth Surgically removed hard or soft tissues Contaminated sharp items Needles Scalpel blades Wires Go into a small red bio-bag and brought to the CSR for disposal |
| What do you do with Instrument Cassettes during breakdown? | Keep gloves on, put instruments back into cassette, put cassette into headrest bag, and take back to CSR Afterward, take off gloves |
| Where does the amalgam scrap and capsule go? | into amalgam scrap container |
| What things go into the sharps container? | Needles, scalpel blades, burs, carpules (glass) |
| What do you need to flush water through at the beginning of the day? | 20-30 seconds each handpiece, air/water syringe, and ultrasonic scaler |
| What all do you need to do to get a cubicle ready? | Clean and disinfect the non-wrapped surfaces Plastic-wrap the keyboard, delivery tray, chair controls, and light Put mouse in headrest bag |
| What are gluteraldehydes? | 6-10 hours immersion required 20-30 minutes for disinfection may corrode instruments is toxic and irritating Instruments must be rinsed afterwards Must store in sterile container |
| What is spore testing? | AKA biologic monitoring Non-pathologic spores on paper strips, vial sterilized in autoclave, and then sent to lab for analysis If spores killed: sterilizer working Recommended to do once per week |
| When are handpieces activated? | Handpieces are activated when they are lifted. A switch in the holder will turn on the fiber optic in the 1st handpiece ONLY and air in 2nd and air in the 3rd. REMEMBER THIS |
| What is the focal length of the light? | ~30 inches |
| What is a class 5 integrator? | A thing in every cassette and pouch sterilized that tells whether the sterilization cycle has reached time, temperature, and presence of steam. Does not replace weekly spore testing Look to see if dark bar has reached the "safe" area |
| What is a chemiclave? | Steam under pressure with chemical vapor (often formaldehyde) Shorter cycle, but hazardous chemical vapor |
| What is dry heat? | 320 degrees for 2 hr or 338 degrees for 1 hr doesn't dull cutting edges or rust, but long cycle and handpieces won't tolerate Poor penetration |
| What are flash sterilizers? | Use steam (273 degrees/30 psi for 3-10 min) Not intended to be used as sole or primary method of sterilization UMKC doesn't have these |
| What are autoclaves? | Steam under pressure (250 degrees @ 15psi for 20 min) Most common (UMKC only has these) Dulls cutting edges and rusts (only disadvantages) |
| What is in a Basic Oral Exam tray? | Mirror, explorer (double-ended), periodontal probe, air/water syringe tip |
| What is the Instrument Management System? | Most instruments in tray sets based on procedures Metal cassettes |
| Why don't you have patient close lips around saliva ejector? | Encourages backflow even though we have anti-retraction valves |
| How much more effective are ultrasonic cleaners than hand scrubbing? | 16x |
| What happens if UMKC has a boil-water advisory? | Stop using units, flush lines for 1-5 minutes, and disinfect waterlines |
| How is surgical water sterile? | Bypasses the dental unit and tubing is sterilized |
| What are options for treating waterlines? | Antiretraction valves, coated tubing, separate waterlines, filtration, and ozination |
| What CFU should water be at? | <500 |
| What is biofilm? | Slime layer formed by bacteria as a nutrient source and source of protection Dental units = small lumens Laminar flow near biofilm is nearly zero, but negligible disruption with flushing |
| What should we do with extracted teeth? | Dispose in medical waste container If given to lab, intermediate level disinfect If given to patient, no regulations Use in preclinical lab: cleaned, put in container with 1/3 bleach, 1/3 water, 1/3 g with biohazard label Autoclave if no amalgam, formalin for 2 wks if amalgam |
| Where are the eyewash stations? | Dispensary, CSR, Team 1, and first floor lab |
| What is the needlestick protocol? | 1. Wash with soap and water 2. Contact: Dana Linville, Dr. Wells, Valorie Moore-Porter, or Jennifer Smith 3. Fill out Incident Report form 4. During normal hours, go to TMC's Occupational Health Dept 5. After hours, call TMC's ER department, ask to speak to the charge nurse |
| What do you do if you test HIV+? | Report it to Assoc. Dean of Clinical Affairs (Dr. Linda Wells) |
| There are work restrictions if you are actively infected with... | Diphteria, Hep A (until 7 days after jaundice), Hep B (until HBV antigen negative), Measles (until 7 days after rash), Mumps, Pertussis, Rubella, Varicella, or Meningococcus (until 1 day after you start meds) |
| How long can Zika virus survive on surfaces? | up to 8 hrs |
| If a patient has TB... | Use respiratory protection, adequate ventilation, and patient isolation Postpone non-emergent procedures |
| Average risk of virus transmission after needlestick | Hep B: 1-31% Hep C: 0-7% HIV: 0.3-0.5% |
| What is the HIV postexposure protocol? | Needlestick: soap and water Mucosal splash: water Antiseptic: no evidence for or against (don't use bleach) Report and fill out paperwork promptly Antiretroviral drugs |
| Risk of HIV transmission | Single needlestick = 0.3-0.5% risk Mucous membrane exposure: 0.1% risk Intact skin exposure: <<0.1% risk |
| Why is HIV transmission so rare? | Dies in seconds on exposure to air |
| What is Hepatitis D? | Only occurs with HBV (4% of HBV+ people) Causes higher rate of mortality (makes HBV more dangerous) |
| What is Hepatitis C? | Not transmitted efficiently by occupational blood exposure Usually by needlesticks |
| What is Hepatitis B? | Survives for up to 1 week on a surface 10% chronic carriers 1% infected Vaccine available |
| What type of blood-borne pathogen transmission is most likely? | Patient --> DHCP |
| What is allergic contact dermatitis? | Type IV delayed hypersensitivity May result from allergy to chemicals used in glove manufacturing |
| How can we minimize latex allergy issues? | Dry hands completely before donning gloves, use only latex-free and powder-free |
| What is contact dermatitis? | Irritant contact dermatitis NOT an allergy Dry, itchy, irritated areas |
| What is Type I hypersensitivity? | Reaction to natural rubber latex proteins "True allergy" Reactions can be serious and may include nose, eye, and skin reactions plus respiratory distress |
| Which hand cleaning agent is most effective? | Alcohol rub Hands have to be generally clean first! |
| When to wash hands? How long? | 15 SECONDS When you wake up, before and after gloves, after bathroom, after petting animals, before eating, and between patients |
| How efficient are masks? | 95% filtration efficiency for bugs >3 microns |
| When do you have to change your mask? | When changing patients, a mask becomes damaged or damp, and every hour if heavy aerosol |
| Where can you find face shields? | Available in CSR and oral surgery Don't have to use! Have to use with mask and clean b/w patients |
| When do you have to wear a mask? | Always when in cubicles when working inside the mouth or using an aerosol-generating instrument |
| What things are CDC guidelines concerned with? | Blood, secretions, saliva, excretions (except sweat), non-intact skin (wounds), mucous membrane exposure (oral and nasal) |
| What is considered under OSHA regulated waste? | Blood or OPIM in liquid or semi-liquid state, items caked with dried blood or OPIM that may release it, contaminated sharps, and pathological or microbiologic waste that contains blood or OPIM |
| What is OPIM? | Other Potentially Infectious Material Includes: semen, vaginal secretions, CSF, synovial fluid, pleural fluid, peritoneal fluid, amniotic fluid, saliva, any body fluid contaminated with blood, all body fluids if you can't differentiate b/w them, any unfixed human tissue or organ |
| What are work practice controls? | Procedures that reduce the likelihood of exposure to infectious materials by altering the manner in which a task is performed Examples: recapping a needle using one-handed scoop |
| What are engineering controls? | Devices that isolate or remove the risk of exposure to bloodborne pathogens in a workplace Examples: use of cassettes, sharps containers |
| What are administrative controls? | The policies, procedures, and enforcement measures targeted at reducing the risk of occupational exposure to infectious persons Example: postponing non-emergency treatment of patients having active TB |
| What is OSHA? | Occupational Safety & Health Administration Federal or State run program with force of law behind it designed to protect employees |
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