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Sedation: Who Provides Anesthesia? Several types of medical professionals are able to provide anesthesia, including: Physicians (anesthesiologists) Nurse anesthetists Dentists/oral surgeons Anesthesiologist assistants The level of training varies between different types of providers, with anesthesiologists having the highest level. If you are receiving nitrous oxide (laughing gas), you will be fitted with a small mask inhale the anesthesia. If intravenous (IV) sedation is used, a needle is placed in the vein to administer the sedative. Regional Anesthesia Regional anesthesia is provided by injecting specific sites with a numbing medication. This may be done with a needle or via a flexible catheter line through which anesthetics and other medications can be administered as needed. With this type of anesthesia, only the body part being operated on is numbed, which means you are awake—that is, sedated, but still conscious—during the procedure. The anesthetic works on the nerves, causing numbness below the injection site. You are monitored throughout your procedure. Your anesthesia provider will continuously monitor your vital signs, including heart rate, blood pressure, and breathing, during your procedure. Local Anesthesia This type of anesthesia is typically used to numb a small site for minor procedures ,a numbing medication is either applied to the skin as a cream or spray, or injected into the area where the procedure will be performed. Monitored Anesthesia Care (MAC) This is a type of sedation commonly referred to as "twilight sleep." It's usually used for outpatient procedures to make you feel sleepy and relaxed. While you may be heavily sedated, this type of anesthesia is different from general anesthesia because you are not chemically paralyzed, nor do you require assistance with breathing. Still, your vital signs are closely monitored to make sure you're stable throughout the procedure. This type of anesthesia wears off in as little as 10 minutes. Depending on the medications used and the doses given, you may or may not remember the procedure. When the surgery is done, other medications can be used to reverse the effect of the anesthesia. You will also be monitored in this recovery phase. After the procedure is complete, the nitrous oxide gas or IV drip is stopped, and you'll be brought slowly out of sedation. They control the level in your body by increasing, decreasing, or eventually stopping the infusion, which wakes you up.

June 11, 2014 • Anesthesia induces a deep state of unconsciousness in a matter of seconds, but it can take several hours to return to normal after waking. Many people experience confusion, sleepiness, and even delirium. Consciousness is the awareness of subjective states such as emotion, inner thoughts, ideas, intentions, and mental states. Without consciousness, an organism has no awareness, while consciousness is often explained as the awareness of emotion, the ability to think and to remember past events and anticipate current ones. General anesthesia affects your entire body. Other types of anesthesia affect specific regions. Most people are awake during operations with local or regional anesthesia. General anesthesia dampens stimulation, knocks you unconscious and keeps you from moving during the operation. General anesthesia has 3 main stages: going under (induction), staying under (maintenance) and recovery (emergence). A specially trained anesthesiologist or nurse anesthetist gives you the proper doses and continuously monitors your vital signs—such as heart rate, body temperature, blood pressure and breathing. The first is an inability to remember things, but can’t recall them after waking up. Next, patients lose the ability to respond. Finally they go into deep sedation. General anesthesia looks more like a coma—a reversible coma. You lose awareness and the ability to feel pain, form memories and move. Once you’ve become unconscious, the anesthesiologist uses monitors and medications to keep you that way. Lack of Consciousness. Keeps you from being aware of your surroundings. Analgesia. Blocks your ability to feel pain. Amnesia. Prevents formation of memories. Loss of Movement. Relaxes your muscles and keeps you still during surgery. Stable Body Functions.

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Tip: At most doctor’s offices, you can request to have a chaperone with you in the room during the exam, such as a nurse or a family member. Sometimes it can be helpful to have someone else in the room if you’re feeling nervous.

Date: 15/12/22 Autistic qualities such as differences in how we understand what our body is feeling (interoception), our experience of pain (hypo/ hyper sensitivity) and difficulties in noticing and identifying how we feel (alexithymia) Nurse practitioners and doctors may have a limited understanding of the unique and significant ways in which autism and its associated issues impact a patient’s experience of a given medical procedure. This means that the particular supports that might help to alleviate discomfort could be lacking. We might encounter resistance to our own attempts to self- regulate and take care of our sensory and emotional needs during the appointment. We may even experience medical gas lighting or invalidation when attempting to express our experience or request much needed accommodations ( we know that this happens at higher rates amongst female presenting people, people of colour and those with additional learning disabilities in our community). For those of us with a history of these types of experiences, just being in a medical environment could feel threatening and unsafe. * Autistic person with a particular set of qualities and traits, this is not a prediction of what others might encounter or an attempt to generalise my own experience to the broader community. Date: 15/12/22

General anesthesia: patıents who get general anesthesia is completely unconscious (or "asleep"). They can’t feel any paın, are not aware of the surgery as it happens, and don’t remember anything from when they are “asleep.” Patients can get general anesthesia through an IV (into a vein) or inhale it through their nose and mouth. With general anesthesia, you're typically given a combination of medications through a mask or intravenous (IV) needle. This will render you temporarily unconscious. The combination of medications used to put patients to “sleep” before surgery or another medical procedure is called general anesthesia. Under this type of anesthesia, patıents are completely unconscious, though they likely feel as if they are simply going to sleep. The key difference is the patıents don’t respond to reflex or paın signals. Regional anesthesia: This type of anesthesia may be injected near a cluster of nerves in the spine. This makes a large area of the bødy numb and unable to feel paın. Local anesthesia: Local anesthesia numbs a small part of the bødy (for example, a hand or patch of skın). It can be given as a shot, spray, or ointment. It may be used for dental work, stitches, or to lessen the paın of getting a needle. General and regional anesthesia are used in hospitals and surgery centers. These medicines are given to patients by specially trained doctors (anesthesiologists) or nurses (nurse anesthetists). Health care providers can give patients local anesthesia in doctors’ offices and clinics. Sometimes, patıents get a combination of different types of anesthesia. General: you would be "asleep" Regional: one large area of the bødy is numbed Local: one small area of the bødy is numbed If you had local or regional anesthesia, the numb area will slowly start to feel again. You then may feel some discomfort in the area. Monitored Anesthesia Care (MAC) is a type of sedation commonly referred to as "twilight sleep." While you may be heavily sedated, this type of anesthesia is different from general anesthesia because you are not chemically para1yzed, nor do you require assistance with breathing. Still, your vital signs are closely monitored to make sure you're stable throughout the procedure. This type of anesthesia wears off in as little as 10 minutes. Depending on the medications used and the doses given, you may or may not remember the procedure. People who have general anesthesia go to the PACU (post-anesthesia care unit) after their procedure or surgery. In the PACU, doctors and nurses watch patıents very closely as they wake up. Some people feel irritable, or confused when waking up. They may have a dry throat from breathing tubes. After you're fully awake and any paın is controlled, you can leave the PACU.

Date: 15/12/22 Support Tips: Preparation: in order to best prepare some actions might include ~ Considering your sensory needs- pack a bag with sensory aids such as headphones, earplugs, coloured glasses, stim tools, comfort items and so on to support your comfort whilst at your appointment. Considering your communication needs- perhaps take a trusted friend or family member to support with verbal communication, a hospital passport that you can share with staff or notes including scripted comments or responses that you can refer to during the appointment to support with or replace verbal speech. Wear suitable clothing that can be easily taken on and off. To minimise uncertainty, research what is involved in the procedure before attending so that you have a good idea what to expect. Write out a list of questions to avoid relying on memory during a potentially stressful experience. Plan your travel route in advance and leave plenty of time to get to your appointment to minimise anxiety and allow time to adjust to the environment upon arrival. Engage in calming, grounding techniques prior to the appointment start time. During: whilst at the appointment it may be helpful to ~ Ask for the nurse practitioner to talk you through the procedure in full before it commences, preferably with use of images or demonstrations with relevant equipment. Be open about which aspects of the experience you might struggle with as an Autistic person and request particular adjustments. Engage in grounding techniques such as mindful breathing. Hold on to a stim object that is comforting or acts as a stress reliever. Listen to music to support self-regulation. Share your concerns or worries with the nurse practitioner to invite reassurance or helpful advice. Remember your reason for attending and why it is important for you. Aftercare: following the procedure, it is a good idea to plan in some time for self-care and self-regulation, some ideas might include ~ Get yourself into a sensory safe space where things feel predictable and calm (for e.g. a quiet room with dim lighting, weighted blanket etc). Arrange to debrief/chat to a friend or another supportive person about your experience after leaving your appointment. Arrange to meet with a trusted person following the procedure to support you with getting back home or perhaps to do something you might enjoy together. Engage in your dedicated interest. Acknowledge your achievement in attending and getting through the appointment. Journal about your experience to help with emotional processing. Engage in your favourite stim to release any tension that may remain in your b0dy. Allow yourself to physically rest or sleep once back at home. Date: 15/12/22

These levels of sedation under anesthesia are defined by the American Society of Anesthesiologists (ASA) and are crucial in determining the appropriate level of sedation for each patient and procedure, ensuring patient safety and comfort throughout the perioperative period. Minimal Sedation: Also known as anxiolysis, minimal sedation involves a drug-induced state during which patients respond normally to verbal commands. Their cognitive function and physical coordination remain unaffected, and there is no compromise in airway reflexes or protective reflexes. This level of sedation is commonly used for procedures requiring minimal discomfort or anxiety relief, such as minor dental procedures or diagnostic tests. Moderate Sedation/Conscious Sedation: Moderate sedation, also referred to as conscious sedation, induces a drug-induced depression of consciousness, during which patients respond purposefully to verbal or light tactile stimulation. While maintaining spontaneous ventilation, patients may experience decreased anxiety and may have impaired cognitive function and physical coordination. However, they retain the ability to maintain their own airway and respond to commands. This level of sedation is commonly used for procedures such as endoscopic examinations, minor surgeries, or interventional radiology procedures. Deep Sedation: Deep sedation involves a drug-induced depression of consciousness, during which patients may not respond purposefully to verbal or tactile stimulation. Patients under deep sedation may require assistance in maintaining their airway, and spontaneous ventilation may be inadequate. However, patients still maintain cardiovascular function. This level of sedation is often used for procedures requiring significant analgesia and amnesia, such as major surgical procedures or certain diagnostic imaging studies. General Anesthesia: General anesthesia involves a drug-induced state during which patients are unarousable, even in the presence of painful stimulation. Patients under general anesthesia require assistance in maintaining their airway and ventilation, and cardiovascular function may be impaired. General anesthesia is characterized by a complete loss of consciousness and protective reflexes, allowing for surgical procedures to be performed without pain or awareness. This level of sedation is utilized for major surgical procedures or invasive diagnostic procedures where unconsciousness and muscle relaxation are necessary. Procedural sedation and analgesia (PSA) is a technique in which a sedating/dissociative medication is given, usually along with an analgesic medication, in order to perform non-surgical procedures on a patient. The overall goal is to induce a decreased level of consciousness while maintaining the patient's ability to breathe on their own. Airway protective reflexes are not compromised by this process

💙 Most kids with ASD are either hypersensitive or hyposensitive to stimuli like noises, lights, touch, etc. If someone has Autism and/or PTSD, he/she may be more prone to sensory overload and startle more easily. That means there’s not much information about how typical treatment methods can or should be adjusted for patients with ASD. According to this article, a nurse could… Offer home-based services Use more visual aids, such as gradient scales to describe degrees of emotion Keep appointment times regular and predictable as much as possible Provide sensory toys or allow children to bring their own Emphasize the possibility of a “happy ending” after trauma―​“this correlates well with the documented effectiveness of social stories, narratives and role-playing in therapy involving individuals with ASD” Be mindful of how often society dismisses the emotions of autistic people Involve other trusted caregivers …and more. Essentially, the therapist should keep the child’s unique strengths and limitations in mind at each step and be open to flexibility. Remember to… Not take behavior personally Be willing to listen without pressuring him/her to talk Identify possible triggers and help him/her avoid them Remain calm and understanding when he/she is emotional Let him/her make age-appropriate choices so he/she feels in control of his/her life Be patient 💙

🍑 what has been said about self collected samples for pap ‘After I made the choice, the only thing that worried me was that I wouldn’t do it properly,’ she recalls. ‘But the instructions were very clear and easy to follow, so that made me feel better about it. I’d say it was much quicker and more comfortable than doing the old Pap test, and I liked that I could do it in private.’ -Patient The Department of Health and Aged Care : (HPV) – a common infection that causes almost all cervical cancers. If you are eligible and want to collect your own sample, your healthcare provider can give you a swab and instructions. A self-collected sample is taken from there so you don’t need to worry about reaching the cervix or ‘getting the right spot’. All you need to do is insert a swab a few centimetres into and rotate it for 20 to 30 seconds. Yes, it’s accurate Evidence shows a Cervical Screening Test using a self-collected sample from there is just as accurate at detecting abnormalities such as HPV as a clinician-collected sample taken from there during a speculum examination. ‘Because my doctor was so reassuring about my ability to self-collect, and the quality of the results that will come back, I found the whole experience really positive. I will definitely choose to self-collect again.’ -patient 🍑

💙 https://www.spectrumnews.org/features/deep-dive/unseen-agony-dismantling-autisms-house-of-pain/ 💙

💉 I'll have it done under general anaesthetic. 💉

Shopping Cart Open mobile menu Menu VACCINATIONS Do adults really need tetanus booster shots? May 14, 2020 By Sara W. Dong, MD, Contributor, and Wendy Stead, MD, Contributor GettyImages-1027752634 If you haven't had a tetanus booster shot in the past decade, your doctor may recommend getting one. Many people think of a tetanus shot as something you only need if you step on a rusty nail. Yet even in the absence of a puncture wound, this vaccine is recommended for all adults at least every 10 years. But why? A group of researchers recently questioned whether you need to repeat tetanus vaccines on a regular schedule. What is a tetanus booster? Booster shots are repeat vaccinations you receive after your first series of immunizations as a child. Protection from certain vaccines can wane over time, which is why doctors advise boosters. The tetanus vaccine is not just for tetanus though. It's bundled with a vaccine for diphtheria and sometimes one for pertussis (the bacteria that causes whooping cough). Protect yourself from the damage of chronic inflammation. Science has proven that chronic, low-grade inflammation can turn into a silent killer that contributes to cardiovas­cular disease, cancer, type 2 diabetes and other conditions. Get simple tips to fight inflammation and stay healthy -- from Harvard Medical School experts. LEARN MORE View Protect yourself from the damage of chronic inflammation. Couple running in woods What are tetanus and diphtheria? Tetanus and diphtheria are rare but serious diseases that can cause severe complications in those infected. Tetanus, sometimes known as "lockjaw," is an infection caused by a type of bacteria called Clostridium tetani. When this bacteria invades the body, it can produce a toxin that leads to painful muscle tightening and stiffness. In severe cases, it can lead to trouble breathing, seizures, and death. Tetanus does not spread from person to person. Usually it enters the body through contaminated breaks in the skin — stepping on a nail that has the bacteria on it, for example. There are about 30 reported cases of tetanus in the US each year. These cases almost always occur in adult patients who have never received a tetanus vaccine, or adults who have not been up to date on their 10-year booster shots. Diphtheria is a bacterial infection caused by a type of bacteria called Corynebacterium diphtheriae. Diphtheria can cause a thick covering on the back of the throat and may lead to difficulty breathing, paralysis, or death. It typically spreads person-to-person. There have been fewer than five cases reported to the CDC in the past 10 years. What are the current vaccine recommendations? The Centers for Disease Control and Prevention (CDC) recommends tetanus vaccines for people of all ages. Adolescents and adults receive either the Td or Tdap vaccines. These vaccines protect over 95% of people from disease for approximately 10 years. Currently the CDC Advisory Committee on Immunization Practices recommends a booster shot every 10 years. Injury or wound management and pregnancy may affect this schedule. What does the new study on tetanus boosters suggest? A recent paper published in the journal Clinical Infectious Diseases suggested that tetanus and diphtheria booster vaccines are not necessary for adults who have completed their childhood vaccination series. This advice aligns with the current World Health Organization (WHO) recommendations. The researchers reviewed WHO data from 31 North American and European countries between 2001 and 2016, amounting to 11 billion person-years. (Person-years is a measurement that reflects the number of people in the study multiplied by years followed). After comparing the incidence of tetanus and diphtheria, they found no significant difference in disease rates in countries that require adults to receive booster shots compared with those that do not. Based on this, the authors suggest that childhood vaccination alone protects sufficiently against tetanus and diphtheria without booster shots. So, what should you do? The question of whether to have ongoing booster vaccines is more complicated than looking at frequency of a disease. The conclusions of this study focus on the lack of change in tetanus or diphtheria incidence rates among countries that routinely vaccinate children. However, other factors influence the number of cases, such as the overall amount of the bacteria in the environment, or wound management and hygiene measures. Immunity from antibodies to tetanus and diphtheria may persist for many years. Over time, though, antibody levels decrease. We know that even if antibodies are present, low levels may not always be protective. Even though this study was well executed and raises some important questions, further studies are needed to examine whether a childhood vaccination series offers lifelong protection without repeated adult boosters. Even though it happens rarely, people can still get tetanus and experience serious or deadly effects. There is no cure for tetanus, and no definitive proof that you will have lifelong immunity with childhood vaccinations alone. So for now, the CDC continues to recommend booster vaccines every 10 years to help your immune system protect against these infections. If you have questions about the tetanus and diphtheria vaccine, talk to your doctor.

|🥩💉🩸🏥|~Bloody hospital~|🏥🩸💉🥩|

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