Dental anesthesia

[Oggg]

We are looking at providing dental anesthesia for a local pediatric dental school. Anyone have experience with the financial side or the clinical side of this? If it's all medi-cal we'd probably never make money, but maybe since it's a school it would attract insured patients. On the clinical side, they asked us how young would we go. We said we need more information -- we are not a peds group, so funny looking kids and neonates are out. But I figure we can do healthy peds >1y and 10lbs. I wonder if a lot of cases could be just IM/PO benzodiazepines/narcotics, or would they be propofol drips?

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[Idiopathic]

i wager the clients will want you because of propofol.

 

[nycitygas]

We are looking at providing dental anesthesia for a local pediatric dental school. Anyone have experience with the financial side or the clinical side of this? If it's all medi-cal we'd probably never make money, but maybe since it's a school it would attract insured patients. On the clinical side, they asked us how young would we go. We said we need more information -- we are not a peds group, so funny looking kids and neonates are out. But I figure we can do healthy peds >1y and 10lbs. I wonder if a lot of cases could be just IM/PO benzodiazepines/narcotics, or would they be propofol drips?

My wife is a pediatric dentist and her practice contracts with pediatric group in the area. I believe its GA with a ventilator and sevo but I can let you know for sure next month when she has her first case.

I believe they charge 800 per hour...cash up front

 

[RU2003]

Did a bunch of these in training. We did GA with nasal RAE for all, most of these kids have rotten teeth with dental residents training and taking awhile

 

[G0S2]

Do a bunch in my current gig. All nasal tubes. Mix of insurance. Nobody less than 2. Did a 5 yr 70 kg with HTN and OSA though.

 

[painstop]

Do you still use the Afrin nasal spray in pre-op followed by the nasal trumpet (bathed in viscous lidocaine or Surgilube) followed by a warmed up nasal RAE with the Magills (usually not needed since it's generally a straight shot) like they taught me in residency? Haven't done one of these in a long time.

 

[G0S2]

Afrin while masking and nurse places iv. Usually then give a little propofol and fentanyl before intubation. Just lube up warm nasal Rae and pop in. McGills if I need them. I secure tube and they wrap head with towel. Tube and circuit taped to head on top of wrap.

 

[Oggg]

The syndromic stuff sounds scary (Pierre robin?). Would they be referred out to a peds hospital? If we set up shop at the school, how much difficult airway stuff should we stock? Having both FOB and Glidescope would be super expensive. Bougie, pedi LMAs, cric kit, McGrath MAC...