Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Miscellaneous issues6. The patient should be informed of the high surgical risk andconsequences of bleeding and possible cardiac complications.Dental damage during anaesthesia[Appraised by Dr Edwin Borman, January 2010]Damage to teeth and crowns can occur during anaesthesia despiteyour best efforts to avoid it. The usual immediate action is toapologise to the patient who has suffered such damage.Then:• Make a note of the nature and extent of damage and agree thiswith the patient if possible. The maxillofacial unit may be able toassist in this; they may be able to repair damage such asavulsed teeth. Please keep the avulsed tooth in a small beakerof normal saline and seek assistance as soon as possible.• Advise the clinical director and the divisional operations directorof the patient details (see page 251).• Complete and submit a clinical adverse event form.• Prepare the first draft of a letter, stating the damage sustainedand that UHCW will cover the cost of repair. Show the letter tothe clinical director before giving it to the patient, (the clinicaldirector will assist with writing such a letter if required). Thengive the letter to the patient, and advise them to attend their owndentist and make arrangements for repairs. Note that the dentistmay need to refer the patient on to a restorative dentist.• The invoice should be sent to the divisional operations directorwho will arrange for payment to be made directly to the dentistconcerned.Teeth guards are available if you ask. You should also consider theroutine use of a bite block while being aware of the balance betweenprotection of teeth, support and protection of the airway device, andthe possibility that the block may itself cause airway obstruction ifaccidentally retained in the patient. Note for example that the200 Anaesthetists Handbook January 2010