What is the best management real-world management for bleeders after an extraction? We're talking about our healthy patients (who are otherwise low risk and not taking funky anti-coagulants).
From wetting our gauze and correct post-op instructions, Dr Ameer Alloybocus and I cover this foundational topic with our real world experiences (including what to do if you hit an arteriole and it's a spurter!).
https://youtu.be/mLPqyI-g_ZI
Watch PDP166 on Youtube
Need to Read it? Check out the Full Episode Transcript below!
Protrusive Dental Pearl: Have a PLAN for your extractions. Just like you have a plan for a crown preparation. For example, you should plan the sequence and also contingencies for when things do not follow your 'Plan A' - including at WHICH POINT you may decide to section the roots or raise a flap.
Post Op Instructions Video by Dr Allybocus as promised on the Podcast
Please do donate to Nafisa so we can saver her life and get her the genetic therapy she needs! She is the daughter of a Protruserati and I want to thank everyone who has donated so far or shared the video message.
Both Ameer and I have done Dr Nekky Jamal's online course on Third Molar Extractions - CLICK HERE to get 15% off (or just use the coupon code 'protrusive'). This is an affiliate link and I am proud to support such an awesome course.
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If you enjoyed this episode, you will also like Make Extractions Less Difficult: Regain Confidence by Sectioning and Elevating Teeth [B2B] – PDP085
Click below for full episode transcript:
Episode Teaser: It's very important to curettage your sockets. So I'd removed the lower left six with a very large abscess underneath it. So I was curetaging away all the tissue and everything that was left behind. Everything was going really well. I was very pleased with myself. I was 20 minutes ahead on my diary.
And, until I noticed a little pumping and spurting coming from the base of the socket, and what had happened was, by, after curettaging, I'd hit an accessory vessel that had found its way superiorly into the socket and this wasn't just a little ooze bleed, this was actually, like, an arterial bleed from an accessory vessel. Now, when I saw that there's a few different ways you can manage this.
Jaz's Introduction:Hello Protruserati, I'm Jaz Gulati, and this was such a geeky chat about extractions. Like, recently we had a geeky chat on onlays with Dr. Ash Lifts, and she was brilliant. And Dr. Ameer Allybocus today covers real world exodontia.
Like, imagine you have a bleeder. What are the best ways to manage a bleeder, both in the short term and in the long term? And unlike all the papers we read or all the other lectures we go to about this, we actually go straight for the kill. Like, what I mean is all the information that you could gain from guidelines.
Like there are some guidelines in the UK, there are guidelines all around the world, basically, wherever you practice, about how we should manage patients who are high risk of bleeding. Now, it didn't feel as though it was worth your time to just revise all the guidelines, because you guys can just easily pick up the guidelines and read them.
So, the kind of scenarios we discuss are the ones whereby you've done all the medical history checks, you've done all the medicine checks, and you've got a normal bleeding wrist patient, yet they still bleed afterwards. Or they call you eight hours later and they say they're having a bit of a bleed. How do you manage those scenarios? And then much, much more. We just really go in deep into all the facets of exodontia.
Protrusive Dental PearlThe Protrusive Dental Pearl is very relevant to Exodontia and something that we actually discussed in this episode.
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