Citing recent cases where children have died during or shortly after undergoing dental procedures and surgery, the Physician-Patient Alliance for Health & Safety (PPAHS) is calling for greater awareness of the risks of anesthesia among parents and better employment of safety standards among practitioners.
For example, 6-year-old Caleb Sears of the San Francisco Bay area of California went to an oral surgeon to have a tooth extracted in March 2015. The oral surgeon who performed the extraction also was responsible for administering the anesthesia. The boy stopped breathing after the anesthesia was administered, suffered from irreversible and massive injuries, and died.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry have jointly released guidelines that state a clinician other than the practitioner must be present with the sole responsibility of monitoring physiologic parameters, administering drugs or directing their administration, and assisting in supportive or resuscitation measures if necessary when children are sedated.
The PPAHS believes that a lack of adequately trained support personnel and monitoring equipment led to the boy’s death. As a result, the group encourages parents to ask clinicians a series of questions before agreeing to procedures involving moderate sedation or general anesthesia:
- Will there be a clinician trained in anesthesia present to administer and monitor the anesthesia consistent with recent pediatric guidelines in addition to the practitioner performing the procedure?
- What type of monitoring equipment, such as capnography, an EKG, or continuous pulse oximetry, will be used during the procedure?
- What type of resuscitation equipment and emergency plans are available in the office where the procedure will be performed?
If the clinician does not answer these questions satisfactorily, the PPAHS says, parents should consider finding another clinician to perform the procedure.