ABSTRACT
A review of the literature revealed that the overarching risk to children and young people around the time of expulsion from school was social exclusion. Factors such as gender, antisocial behaviour, crime, drug taking and suicide were also identified as risks. The effects of the increased use of short-term and in-house exclusions, and poor parental control, also emerged within this area. In considering application to practice, the specialist community public health nurse (SCPHN) needs to work as part of a multidisciplinary team offering targeted support to those most vulnerable, together with preventive work via the Personal, Social and Health Education (PSHE) curriculum.
Subject(s)
Depression/prevention & control , Public Health Nursing/education , School Nursing/methods , School Nursing/organization & administration , Social Stigma , Suicide Prevention , Adolescent , Child , Human Rights , Humans , Risk Factors , School Admission Criteria , Schools , United KingdomABSTRACT
Anesthesia-related morbidity is a serious risk to oral and maxillofacial surgery patients receiving outpatient surgery. Unfortunately, there is little data to track the risks of outpatient anesthesia to offer as an appeasement for these concerns. The most recent and comprehensive review is the American Association of Oral and Maxillofacial Surgeons (AAOMS) anesthesia study published in 2003. In an insurance claims analysis, Deegan presented data that the mortality risk in the oral surgery office was 19 deaths in 14,206,923 anesthetics administered.
ABSTRACT
PURPOSE: To document the incidence of specific complications and the mortality rate for office anesthesia administered by fully qualified oral and maxillofacial surgeons in the state of Massachusetts. MATERIALS AND METHODS: A survey questionnaire was mailed to the 169 active members of the Massachusetts Society of Oral and Maxillofacial Surgeons. Using a specific method for follow-up, a 100% response was obtained. RESULTS: The frequency of office anesthetic complications occurring in 2004 were consistent with our previous studies. There was 1 office death, for a mortality rate of 1/1,733,055. The incidence of other specific anesthetic-related complications is documented. CONCLUSION: From the data presented here, we conclude that outpatient anesthesia in the oral and maxillofacial surgery office continues to be a safe therapeutic modality.
Subject(s)
Ambulatory Surgical Procedures/adverse effects , Anesthesia, Dental/adverse effects , Oral Surgical Procedures/adverse effects , Adult , Aged , Aged, 80 and over , Ambulatory Surgical Procedures/mortality , Ambulatory Surgical Procedures/statistics & numerical data , Anesthesia, Dental/methods , Anesthesia, Dental/mortality , Anesthesia, Dental/statistics & numerical data , Anesthesia, General/adverse effects , Anesthesia, General/mortality , Anesthesia, General/statistics & numerical data , Anesthesia, Local/adverse effects , Anesthesia, Local/statistics & numerical data , Anesthetics, Inhalation/adverse effects , Conscious Sedation/adverse effects , Conscious Sedation/mortality , Conscious Sedation/statistics & numerical data , Female , Humans , Laryngismus/etiology , Male , Massachusetts , Middle Aged , Nitrous Oxide/adverse effects , Oral Surgical Procedures/mortality , Oral Surgical Procedures/standards , Pneumonia, Aspiration/etiology , Surveys and QuestionnairesABSTRACT
PURPOSE: This retrospective study documented the frequency of various complications associated with outpatient anesthesia. PATIENTS AND METHODS: A questionnaire was mailed to the 157 active members of the Massachusetts Society of Oral and Maxillofacial Surgeons (MSOMS) and all members responded. Morbidity data were obtained for the calendar year 1999. Mortality data included 1999 and the preceding 4 years. This continues our long-term survey of ambulatory oral surgical office deaths in Massachusetts since 1984. The data include anesthesia-related complications and all office deaths for the patients treated by these oral and maxillofacial surgeons. RESULTS: The most common complication in our survey continues to be syncope, which occurred in 1 in 160 patients receiving local anesthesia. The incidences of other specific anesthetic problems are given. Two treatment-related deaths occurred among approximately 1,706,100 patients treated during the 5-year period of 1995 through 1999, for a mortality rate of 1/853,050. CONCLUSIONS: The results of this retrospective practitioner survey documented the specific incidence of untoward anesthetic events with outpatient anesthesia and found a mortality rate consistent with the 6 similar mortality studies since 1980. These 7 retrospective reviews found 34/28,399,193 outpatient deaths for an overall dental anesthesia mortality rate of 1/835,000.