Guest guest Posted March 2, 2012 Report Share Posted March 2, 2012 Hi guysIs there anything else do we need to know abt bleeding in ME(apart from physio)Do we need to know exact anmmount of fluid,%...?And it is there a guideline about it? Assess and manage haemodynamic statusClean the mouth with cold waterIdentify the source of the bleedingLocal pressure with gauze packs dampened with adrenaline-containing LA (co-phenylcaine") pack. The child may cooperate to bite down on a damp gauze wad.Consider Tranexamic acidContact the on-call dentistSocket may need suturing For severe bleeding Circulation: IV access x2, FBE, coagulation screen, cross-match blood, IV fluid resuscitation.Keep firm pressure on the site of bleeding as above.ED Consultant/ ICU/ Anaesthetic input.Contact maxillo-facial team SincerelyLyudmyla Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 7, 2012 Report Share Posted March 7, 2012 HHii, there r some questions in ME they asked; - old female with congestive heart failure done extraction at other dentist, now come to ur clinic suffering post- bleeding?. what 5 question u will ask? what 5 systemic condition which predispose to bleeding? what 5 local factors that can cause bleeding? how u manage the pt? Ammar > > Hi guys > Is there anything else do we need to know abt bleeding in ME(apart from physio) > Do we need to know exact anmmount of fluid,%...? > And it is there a guideline about it? > > * Assess and manage haemodynamic status > * Clean the mouth with cold water > * Identify the source of the bleeding > * Local pressure with gauze packs dampened with adrenaline-containing LA (co-phenylcaine " ) pack. The child may cooperate to bite down on a damp gauze wad. > * Consider Tranexamic acid > * Contact the on-call dentist > * Socket may need suturing > > For severe bleeding > * Circulation: IV access x2, FBE, coagulation screen, cross-match blood, IV fluid resuscitation. > * Keep firm pressure on the site of bleeding as above. > * ED Consultant/ ICU/ Anaesthetic input. > * Contact maxillo-facial team > > Sincerely > Lyudmyla > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 7, 2012 Report Share Posted March 7, 2012 How long has been bleeding going for?Amount of blood lost according to patient?( this will always be exaggerated)What medications she is taking and dose?Was the extraction traumatic and did she follow all the post extraction instructions?Was the tooth removed completely or into pieces?Pt on Warfarin or other aniticoagulantsPt having a bleeding disorderPt with uncontrolled DiabetesPt with liver dysfunctionPt with raised blood pressureTraumatic surgeryFrequent Rinsing and Touching wound with finger or tongue after extractionPt having INR not checked before surgery if taking warfarinLa without adrenaline can cause more bleedingIn the management Clean the socket with irrigation ( not saline in this case), chlorhexidineExamine socket for any fractures , left over tooth pieces etc and remove all debrisApply pressure pack and ask patient to bite on it , wait for 15 mins..in the meanwhile check blood pressure and pulseA low blood pressure will indicate increased blood loss and risk of hypovolemia so prepare for hospital shifting of patient(call ambulance, prepare oxygen) where IV line will be passedIf Blood pressure and vitals are normal and bleeding does not stop after 15 mins keep a surgicel dressing or consider tranexamic acidConsider Suturing of socket with dressing insideObserve for another 15 mins and if it does not stops take the patient to A n EA GDP will only manage till here as is his role in GDP and the blood screening and rest will be done in hospital,an IV line can be passed by a GDP but not normally done in practice so i would say its an emergency treatment and should only be considered if really really necessaryPlease correct me or add to itAqsa From: ammar k <ammarkiliddar@...> Sent: Wednesday, 7 March 2012, 9:31 Subject: Re: Bleeding from the socket HHii, there r some questions in ME they asked; - old female with congestive heart failure done extraction at other dentist, now come to ur clinic suffering post- bleeding?. what 5 question u will ask? what 5 systemic condition which predispose to bleeding? what 5 local factors that can cause bleeding? how u manage the pt? Ammar > > Hi guys > Is there anything else do we need to know abt bleeding in ME(apart from physio) > Do we need to know exact anmmount of fluid,%...? > And it is there a guideline about it? > > * Assess and manage haemodynamic status > * Clean the mouth with cold water > * Identify the source of the bleeding > * Local pressure with gauze packs dampened with adrenaline-containing LA (co-phenylcaine") pack. The child may cooperate to bite down on a damp gauze wad. > * Consider Tranexamic acid > * Contact the on-call dentist > * Socket may need suturing > > For severe bleeding > * Circulation: IV access x2, FBE, coagulation screen, cross-match blood, IV fluid resuscitation. > * Keep firm pressure on the site of bleeding as above. > * ED Consultant/ ICU/ Anaesthetic input. > * Contact maxillo-facial team > > Sincerely > Lyudmyla > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 7, 2012 Report Share Posted March 7, 2012 Hi,Read( Mangement of anticoagulation) in Odell for the mangement of the bleeding and for the systemic cause ; read bleeding disorder from Scully eg; Heamophillia.... From: Aqsa Fatima Burki <aqsaburki@...> " " < > Sent: Wednesday, 7 March 2012, 10:10 Subject: Re: Re: Bleeding from the socket How long has been bleeding going for?Amount of blood lost according to patient?( this will always be exaggerated)What medications she is taking and dose?Was the extraction traumatic and did she follow all the post extraction instructions?Was the tooth removed completely or into pieces?Pt on Warfarin or other aniticoagulantsPt having a bleeding disorderPt with uncontrolled DiabetesPt with liver dysfunctionPt with raised blood pressureTraumatic surgeryFrequent Rinsing and Touching wound with finger or tongue after extractionPt having INR not checked before surgery if taking warfarinLa without adrenaline can cause more bleedingIn the management Clean the socket with irrigation ( not saline in this case), chlorhexidineExamine socket for any fractures , left over tooth pieces etc and remove all debrisApply pressure pack and ask patient to bite on it , wait for 15 mins..in the meanwhile check blood pressure and pulseA low blood pressure will indicate increased blood loss and risk of hypovolemia so prepare for hospital shifting of patient(call ambulance, prepare oxygen) where IV line will be passedIf Blood pressure and vitals are normal and bleeding does not stop after 15 mins keep a surgicel dressing or consider tranexamic acidConsider Suturing of socket with dressing insideObserve for another 15 mins and if it does not stops take the patient to A n EA GDP will only manage till here as is his role in GDP and the blood screening and rest will be done in hospital,an IV line can be passed by a GDP but not normally done in practice so i would say its an emergency treatment and should only be considered if really really necessaryPlease correct me or add to itAqsa From: ammar k <ammarkiliddar@...> Sent: Wednesday, 7 March 2012, 9:31 Subject: Re: Bleeding from the socket HHii, there r some questions in ME they asked; - old female with congestive heart failure done extraction at other dentist, now come to ur clinic suffering post- bleeding?. what 5 question u will ask? what 5 systemic condition which predispose to bleeding? what 5 local factors that can cause bleeding? how u manage the pt? Ammar > > Hi guys > Is there anything else do we need to know abt bleeding in ME(apart from physio) > Do we need to know exact anmmount of fluid,%...? > And it is there a guideline about it? > > * Assess and manage haemodynamic status > * Clean the mouth with cold water > * Identify the source of the bleeding > * Local pressure with gauze packs dampened with adrenaline-containing LA (co-phenylcaine") pack. The child may cooperate to bite down on a damp gauze wad. > * Consider Tranexamic acid > * Contact the on-call dentist > * Socket may need suturing > > For severe bleeding > * Circulation: IV access x2, FBE, coagulation screen, cross-match blood, IV fluid resuscitation. > * Keep firm pressure on the site of bleeding as above. > * ED Consultant/ ICU/ Anaesthetic input. > * Contact maxillo-facial team > > Sincerely > Lyudmyla > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 7, 2012 Report Share Posted March 7, 2012 have read them already, thanks From: Asmaa Almaliky <asmaaalmaliky@...> " " < > Sent: Wednesday, 7 March 2012, 10:21 Subject: Re: Re: Bleeding from the socket Hi,Read( Mangement of anticoagulation) in Odell for the mangement of the bleeding and for the systemic cause ; read bleeding disorder from Scully eg; Heamophillia.... From: Aqsa Fatima Burki <aqsaburki@...> " " < > Sent: Wednesday, 7 March 2012, 10:10 Subject: Re: Re: Bleeding from the socket How long has been bleeding going for?Amount of blood lost according to patient?( this will always be exaggerated)What medications she is taking and dose?Was the extraction traumatic and did she follow all the post extraction instructions?Was the tooth removed completely or into pieces?Pt on Warfarin or other aniticoagulantsPt having a bleeding disorderPt with uncontrolled DiabetesPt with liver dysfunctionPt with raised blood pressureTraumatic surgeryFrequent Rinsing and Touching wound with finger or tongue after extractionPt having INR not checked before surgery if taking warfarinLa without adrenaline can cause more bleedingIn the management Clean the socket with irrigation ( not saline in this case), chlorhexidineExamine socket for any fractures , left over tooth pieces etc and remove all debrisApply pressure pack and ask patient to bite on it , wait for 15 mins..in the meanwhile check blood pressure and pulseA low blood pressure will indicate increased blood loss and risk of hypovolemia so prepare for hospital shifting of patient(call ambulance, prepare oxygen) where IV line will be passedIf Blood pressure and vitals are normal and bleeding does not stop after 15 mins keep a surgicel dressing or consider tranexamic acidConsider Suturing of socket with dressing insideObserve for another 15 mins and if it does not stops take the patient to A n EA GDP will only manage till here as is his role in GDP and the blood screening and rest will be done in hospital,an IV line can be passed by a GDP but not normally done in practice so i would say its an emergency treatment and should only be considered if really really necessaryPlease correct me or add to itAqsa From: ammar k <ammarkiliddar@...> Sent: Wednesday, 7 March 2012, 9:31 Subject: Re: Bleeding from the socket HHii, there r some questions in ME they asked; - old female with congestive heart failure done extraction at other dentist, now come to ur clinic suffering post- bleeding?. what 5 question u will ask? what 5 systemic condition which predispose to bleeding? what 5 local factors that can cause bleeding? how u manage the pt? Ammar > > Hi guys > Is there anything else do we need to know abt bleeding in ME(apart from physio) > Do we need to know exact anmmount of fluid,%...? > And it is there a guideline about it? > > * Assess and manage haemodynamic status > * Clean the mouth with cold water > * Identify the source of the bleeding > * Local pressure with gauze packs dampened with adrenaline-containing LA (co-phenylcaine") pack. The child may cooperate to bite down on a damp gauze wad. > * Consider Tranexamic acid > * Contact the on-call dentist > * Socket may need suturing > > For severe bleeding > * Circulation: IV access x2, FBE, coagulation screen, cross-match blood, IV fluid resuscitation. > * Keep firm pressure on the site of bleeding as above. > * ED Consultant/ ICU/ Anaesthetic input. > * Contact maxillo-facial team > > Sincerely > Lyudmyla > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 7, 2012 Report Share Posted March 7, 2012 thanks Aqsa > > > > Hi guys > > Is there anything else do we need to know abt bleeding in ME(apart from physio) > > Do we need to know exact anmmount of fluid,%...? > > And it is there a guideline about it? > > > > * Assess and manage haemodynamic status > > * Clean the mouth with cold water > > * Identify the source of the bleeding > > * Local pressure with gauze packs dampened with adrenaline-containing LA (co-phenylcaine " ) pack. The child may cooperate to bite down on a damp gauze wad. > > * Consider Tranexamic acid > > * Contact the on-call dentist > > * Socket may need suturing > >  > > For severe bleeding > > * Circulation: IV access x2, FBE, coagulation screen, cross-match blood, IV fluid resuscitation. > > * Keep firm pressure on the site of bleeding as above. > > * ED Consultant/ ICU/ Anaesthetic input. > > * Contact maxillo-facial team > >  > > Sincerely > > Lyudmyla > > > Quote Link to comment Share on other sites More sharing options...
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