DAANCE Patient Monitoring Techniques 4 — Questions and Answers
Question 1: A patient under IV sedation suddenly develops a SpO2 reading of 88%. What is the FIRST action the dental anesthesia assistant should take?
- Administer 100% oxygen via nasal hood
- Notify the dentist immediately
- Reposition the patient to supine
- Check that the pulse oximeter probe is properly seated (Correct answer)
Correct answer: Check that the pulse oximeter probe is properly seated
An artifactually low SpO2 reading should first be verified by checking probe placement before escalating to clinical interventions.
Question 2: Which waveform on a capnograph indicates normal ventilation during moderate sedation?
- A flat line at 0 mmHg
- A square-wave pattern with end-tidal CO2 of 35–45 mmHg (Correct answer)
- An irregular waveform with peaks above 60 mmHg
- A continuously rising baseline without a plateau
Correct answer: A square-wave pattern with end-tidal CO2 of 35–45 mmHg
A normal capnogram shows a square wave with an alveolar plateau ending at an EtCO2 of 35–45 mmHg, confirming adequate ventilation.
Question 3: During monitoring, you notice the patient's respiratory rate has dropped to 6 breaths per minute. Which sedation complication does this MOST likely indicate?
- Laryngospasm
- Hyperventilation
- Respiratory depression (Correct answer)
- Vasovagal syncope
Correct answer: Respiratory depression
A respiratory rate below 8–10 breaths per minute is a hallmark sign of respiratory depression, commonly caused by opioid or benzodiazepine oversedation.
Question 4: When using a precordial stethoscope during sedation, the assistant is primarily monitoring for:
- Blood pressure changes
- Breath and heart sounds continuously (Correct answer)
- Capillary refill time
- Pupillary response
Correct answer: Breath and heart sounds continuously
A precordial stethoscope placed over the chest allows continuous auscultation of breath and heart sounds without interrupting the procedure.
Question 5: A patient's blood pressure reading is 158/96 mmHg before a sedation procedure. According to ADA guidelines, the appropriate action is to:
- Proceed normally; this is within acceptable limits
- Postpone treatment and refer the patient for medical evaluation (Correct answer)
- Administer an antihypertensive immediately
- Reduce the local anesthetic dose and monitor closely
Correct answer: Postpone treatment and refer the patient for medical evaluation
A BP of 158/96 mmHg falls into Stage 2 hypertension; elective dental procedures should be deferred and the patient referred for medical evaluation.
Question 6: Which site provides the MOST accurate core body temperature reading in a sedated dental patient?
- Axillary (armpit)
- Oral (sublingual)
- Tympanic (ear) (Correct answer)
- Temporal artery (forehead)
Correct answer: Tympanic (ear)
Tympanic temperature measurement closely reflects core temperature and is practical for use in the dental setting during sedation.
Question 7: During sedation, a Bispectral Index (BIS) monitor reads 45. What level of sedation does this MOST likely indicate?
- Minimal sedation (anxiolysis)
- Moderate sedation (conscious sedation)
- Deep sedation
- General anesthesia (Correct answer)
Correct answer: General anesthesia
BIS values of 40–60 correspond to general anesthesia; moderate sedation typically shows BIS values of 70–85.
DAANCE Patient Monitoring Techniques 4
A patient under IV sedation suddenly develops a SpO2 reading of 88%.
What is the FIRST action the dental anesthesia assistant should take?