GDA Action October 2021

October 2021 • 31 keeps track of what material, what shade, and what medicines we used during the case so we can accurately dictate for clinical, clerical, and insurance purposes. Intra-Operative Consideration #3: Procedures Once the breathing tube is inserted and secured in place, it is our turn to work. My assistant or I pack the throat with a long wet gauze and announce it as our starting time (Photo 6). There are slight variations in treatment sequence in the OR. Following placing the throat pack, my sequence is: photos, intraoral X-rays (if not done in the office), cleaning or non-surgical periodontal care, models if needed, restorative, endo, crown and bridge, then all blood procedures including extractions, perio surgery, tori removal, frenectomies, etc. We want all blood procedures last so as to not contaminate composites or any restorative care. Upon completion, we take final post-op intraoral photos and turn the patient over to the anesthesia team for extubation and transport to the recovery area. Post-Operative Considerations As we step away from the OR table, the medical team takes over. My team and I remove our gowns and gloves, gather up our personal supplies like our laptop, camera, papers, and anything else we brought with us. If we have a case to follow, my staff freshens up and takes a half hour break. If no more cases that day, they are free to leave. As the doctor, I still have a few chores. First, a brief note in the chart is required so the recovery nurse knows what was done. This may be in writing and/or electronically, depending on the institution and their state of the art with Electronic Medical Records (EMR). We then talk with the family or caregivers to inform them how the procedure went, any changes or deviations from the pre-op plan, give them instructions on preprinted sheets, provide any prescriptions either in writing or by calling a pharmacy, and inform them of when we need to see the patient again. Then, if I didn’t already write my discharge orders and operative notes, I do so now. Operative report or procedure notes may be written or dictated, they may be required before the patient » 8-Mobile X-ray with swing arm 11-Protection helmet in wheelchair 5-Oral intubation; NOMAD-Pro; X-ray sensor 9-Nasal intubation; Ergonom-X Self developing dental film 12-Home Call in NYC 6-Throat pack, nasal tube; molt mouth gag 7-Panoramic X-ray with parental assist 10-Protection helmet in bed 13-Dr. Dave Blende home visit