![]() Treatment and recovery after a diagnosis of an SUD is complicated for professionals whose livelihood involves daily exposure to the substances which they misuse. 180 Other issues that may lead to inadequate or unsafe performance may be depression, anxiety, financial difficulties, and family struggles, and other medical illness may manifest in similar ways to SUDs. It is critical that factors other than SUDs be considered, because the “impaired” anesthesiologist is not necessarily an “addicted” anesthesiologist. In either circumstance, access to controlled substances and the operating room is restricted, pending outcome of an investigation. When it is uncertain whether an SUD is the cause of impaired performance, a medical leave of absence is granted pending completion of evaluation and testing. Should an individual refuse to seek care, an immediate report to the Board of Registration in Medicine is made. In the case of admitted or demonstrated SUD, treatment is required. ![]() If additional drug testing is indicated, the individual is escorted for testing. The issues of concern are presented in a supportive and nonconfrontational manner. The individual is removed from clinical duty in a confidential manner. The intervention team discusses each case before meeting with the individual. Other individuals such as a mentor or certified registered nurse anesthetist (CRNA) leader may be included when appropriate. 179 A suggested approach used at MGH is that a consistent team including the director of the SUD prevention program, another department leader, and a designated psychiatrist familiar with SUDs and the department’s policy should be involved in all interventions. Such an “intervention” is more likely to maintain the confidence of the individual than a “confrontation” where the individual feels that guilt is presumed. An organized, structured, and supportive plan to present the concerns to the impaired individual is critical. When an SUD is identified or suspected, it is critical that concerned and compassionate colleagues intervene to prevent injury or harm to patients and to help the impaired individual. 138,139,178 Residents who have an SUD during their training have a markedly increased risk of death after training compared with their colleagues without an SUD. 175 Studies have shown that death is the initial presentation in 9% to 16% of cases. SUDs curtail promising careers and claim the lives of anesthesiologists every year. Gropper MD, PhD, in Miller's Anesthesia, 2020 Intervention, Treatment, Prognosis, and Reentry Without that oversight, there is a greater danger that the knowledge of infection control will be lacking or that lack of infection control will cause problems for the patient. ![]() The dentist makes sure that infection-control procedures are properly carried out. If an esthetic procedure is being carried out without a dentist, such as whitening done in a bleaching center that is operated by non-dentists, there may be a greater risk. There should be little to no risk of infection to the patient or the dental staff during dental procedures.Īs esthetic dentistry is becoming more popular, some dental procedures are being done outside of dental practice sites. ![]() It is the duty of the dentist to ensure that all staff members in the dental office practice good infection control. Esthetic dentistry should not be the exception. Every dentist should practice good infection control. Infection control is of great importance for dental practitioners and patients. Samaranayake, in Contemporary Esthetic Dentistry, 2012 Relevance of Disinfection to Esthetic Dentistry The lessons of past epidemics have been codified into guidelines and training courses that can inform and steer the process of maintaining preparedness. Clinicians can remain vigilant for possible cases, taking careful travel histories and maintaining awareness of current international infectious diseases epidemiology. Patients infected with emerging pathogens do not typically present to health care with a diagnosis, and the transmission dynamics of the pathogen may be unknown, warranting enhanced infection-control measures for suspected cases. Hospitals must be prepared for such possibilities, with procedures and infrastructure poised to contain severe infections that may be highly contagious. As the 2003–04 severe acute respiratory syndrome epidemic, 2014–15 Ebola epidemic, and 2015 Middle East coronavirus outbreaks demonstrated vividly, the regularity of international travel allows importation of infectious agents to distant regions with secondary spread in health care facilities. Hospitals must consider and plan for exceptional infectious diseases events, such as influenza pandemics and the emergence or reemergence of highly contagious diseases. Bennett MD, in Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 2020 Emerging Infectious Diseases
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