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Common Nursing Tools, Procedures And Situations

Question1: Purpose and functions of following equipments used during surgery

a) Topical anaesthetic

It reduced the slightly discomfort which is associated with insertion of needle and affective to a depth of 2mm. It is beneficial for decreasing the patient discomfort during

b) Local anaesthetic

It is an anaesthetic drug which can be given either by spray, shot or ointment on a small patch area on body. It sedates an areas a person for a short period of time during surgery and control post-surgery discomfort as well.  

c) Local anaesthetic syringe and needles

A safety syringe helps in minimizing the risk which may occur during surgery due to accidental needle-stick injury. These syringes and needles includes a sheath which locks over the needle, after removing from the tissues of patients for preventing accidental needle stick.

d) Luxators/elevators

Luxators or elevators are sharper and thinner devices which are designed in extraction of teeth i.e. separate the tooth from its surrounding bones.

e) Extraction Forceps

It includes two blades having sharp edges for cutting the periodontal fibres. It is considered as an elevator to move the tooth 1-3mm by constant steady pressure with wrist.

f) Scalpel

It is an extremely sharp and small bladed instrument which is specially designed for endodontic use. For example: Kerr Endodontics is a disposable scalpels and helps in improving visibility within a microscope that allows for a more precise incision.  

g) Periosteal elevator

This device is used for lifting a muco-periosteal flap off the bone during extraction of tooth.

h) Cheek retractor

Cheek retractors in dental surgery is used to hold the mouth of patients and open it throughout surgery process. It can be disposable or autoclavable, where disposable retractors are made up from clear materials, in order to provide improved visibility.

i) Spencer wells

These are considered as hemostatic forceps which are used to control blood flow within vessels and left to sutured later.

j) Suture and suture holder

Suture and its holder is an artificial fibre used to keep wound to hold until sufficiently by themselves. It is a series of stitches to secure from apposition in a surgery.

j) Dissecting forceps:

Dissecting forceps is an small instrument that should be handled in careful manner and helps in grasp tiny tissues for treatment purpose at time of surgery.

k) Scissors

Scissors use in dental to cutting gauze and bind bandages to an suitable length and size.

l) Surgical suction tip

It is an plastic suction tip use for effective suction for damaging tissues surround mouth and protect from blood loss at time of surgery.

m) Surgical hand piece and burs

Ceramic burs use for dental treatment procedures and carries for removal. Its head contains blades that gives the cutting actions.

n) Irrigation syringe, needle and solution

It use for remove debris, lubricate by root canal walls and helps in dissolve tissues and eradicate bacteria.

o) Haemostatic medicaments

It is useful in oral surgical cases and also useful in surgical procedures to affix haemostasis when traditional procedures not effective.

Question2: Minor oral surgery procedures with equipment and their instruments

a) Implants

It is a surgical component which interface with the jaw's bone or skull in order to support a dental prosthesis. It is biological process which also known as osseointegration where each materials like titanium helps in forming bond to bone.

b) Apicectomy – Include raising the mucoperiosteal flap

It refers to a minor procedure for removal of tip of tooth's root during treatment. Apicectomy is mostly done for front teeth treatment but can be used for back teeth also.

c) Frenectomy

It is performed generally by an oral surgeon who are specialised in improving proper speech, swallowing and movement by free the tongue.

d) Biopsy

It refers to a procedure of treatment where a small piece of tissue removes from an area completely, to confirm a diagnosis.

e) Removal of impacted teeth – Include the occasional need for sectioning

Impacted teeth can be defined as a tooth which is failed to erupt within expected developmental window, into dental arch. Generally, it is essential to remove impacted teeth to avoid future oral problems. It can be removed by tooth sectioning process i.e. impacted tooth cut into sectioned and removed easily.

f) Removal of buried roots

After tooth decay or any trauma, the least part i.e. root remain in jawbone and buried under gum. To remove this part, a soft tissue diode laser is used which cut gums and thereby reduce pain.

g) Removal of erupted teeth

A tooth which is not fully emerged through gums and partially erupted are especially hard to clean. They are also susceptible towards gingivities therefore, surgical extraction is used for removal of suspected teeth.

h) Removal of unerupted teeth and roots.

When teeth fail to grow in correct position and held below the normal gum line then such teeth are called unerupted teeth. These tooth and unerupted roots are removed by extraction, autotransplantation or by exposure with usage of direct mechanical force to tooth.

i) Removal of deciduous teeth

When tooth is damaged due to decay, cavities or infection then they can be extracted by orthodontic treatment (a brace).

j) Bone removal

Surgical tooth removal includes an incision process which is being made in the gum. This could involve the process of bone removal around tooth for providing better access.

Question3: Process of giving POI for following groups

After the dental surgery, it is essential for dentist and other service providers to give proper post-operative instruction (POI). Here, they have to confirm with doctor that whether patient is fit to leave the surgery or not. These instructions are given to patients as per their age factor as shown below:-

a) Adults

Adults may feel throat swelling after dental surgeries to few days which may be resolved without any treatment. So, there is no need to take asprin for pain relief.  Eat soft food for few days including low fibres eatables, to reduce tooth problems.

b) Children and young people

For children, POI states to drink plenty of water within every half an hour to reduce discomfort. Problems like stuff nose, bad breathe and more, can occur till few days after surgery. They should play some games like swimming, football, travelling and more, for recovery of teeth and gums after surgery as well as reduce the chance of failure of surgery.

c) Older people

Special precautions are taken while giving treatment to old age people because after dental surgery, it will take time to recovery. Therefore, complete dietary chart and medicines which can be used to reduce pain is given to older people after surgery.

d) Patients having special needs

For patients having special needs like any health issues, dentist must know the same before surgery. This would help in giving proper instruction related to post-operative for better care of teeth.

Question4: Way to respond for different-different complications

a) Nerve damage

This situation can occur during oral surgery, particularly in implantation process. Here, a nerve injury reflects a complex situation after dental surgery for both patient and doctors. Under this situation, it is better to do some surgical treatment like neurorraphy, decompression, nerve stump intubation and more, for resolving the same.  

b) Haemorrhage

Intervention taken for managing post-extraction bleeding after dental surgery are suturing, fibrin glue having collagen fleece and sutures, recombinant (non-surgical haemostatic measure), tranexamic acid mouthwash including gelatin sponge and sutures etc.

c) Oral antral fistula

For treating oral antral and fistula, several interventions can be used as surgical and non-surgical interventions. It includes soft tissue flaps, grafts, xenografts and more.

d) Equipment failure

Under this case, practice owners should be acknowledged with actions required to handle the case, like to follow some specific protocols.

e) Collapse

For managing any emergency in dental surgery, rendering basic life support (BLS) measures as well as cardiopulmonary resuscitation (CPR) therapy are considered as best option. It can be done only by following some basic principles like Position (P), Airway (A), Breathing (B), Circulation (C), and Definitive therapy. Here, functioning airways and maintaining a patent is taken as first priority for managing emergency conditions like collapse.  

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