Emergency Management in Dental Practice Quiz

Management of Foreign Body Airway Obstruction in Dental Practice

• Retention of consciousness indicates sufficient blood and O2 for cerebral function, but causes acute anxiety.
• Symptoms of breathing difficulty and sounds vary based on the underlying cause.
• Acute asthma primarily affects bronchioles, while hyperventilation originates in the brain.
• Acute foreign body airway obstruction (FBAO) is life-threatening and its severity depends on the level of airway obstruction.
• Dental procedures pose a risk for FBAO, especially in young and sedated individuals.
• Swallowed foreign objects typically pass through the GI tract, but aspiration can lead to serious respiratory complications.
• Preventive measures like rubber dam, oral packing, and ligature help minimize the risk of aspiration or swallowing of objects during dental procedures.
• Rubber dam effectively isolates the operative field and prevents foreign object swallowing.
• Pharyngeal curtain created by gauze pads prevents small particles or liquids from entering the airway.
• Dental floss can prevent aspiration and aid in retrieving objects from the oral cavity and pharynx.
• Objects in the tracheobronchial tree can cause sudden coughing, choking, wheezing, and shortness of breath.
• Acute upper-airway obstruction often occurs during eating and can be complete or partial, with varying degrees of air exchange.

Asthma and Hyperventilation Management

• Hyperventilation management involves correcting respiratory issues and reducing anxiety levels.
• Steps for managing hyperventilation include removing the cause of anxiety, positioning the patient upright, removing foreign materials from the mouth, calming the patient, and correcting respiratory alkalosis.
• Asthma is characterized by extreme airway sensitivity, abnormal secretion generation and clearance, and an abnormally sensitive cough reflex.
• Extrinsic asthma is associated with allergic factors and affects 50% of asthma patients, especially in children and young adults with an inherited allergic predisposition.
• Intrinsic asthma occurs in adults over 35 and is caused by non-allergic factors such as smoking, respiratory infections, and air pollution.
• Asthma attacks can be triggered by allergens, and Singulair is used for severe allergies.
• Important questions to ask asthma patients include inquiries about allergies, medications, and the severity and frequency of asthma attacks.
• Medical management of asthma includes drug therapies such as short-acting beta-2 agonists, inhaled corticosteroids, immune modulators, and long-acting beta-2 agonists.
• Dental considerations for patients with asthma involve maintaining pulmonary status, preventing acute episodes during treatment, and being aware of aspirin sensitivity.
• The American Society of Anesthesiologists (ASA) physical classification system categorizes patients based on their asthma symptoms and control.
• Asthma attacks primarily obstruct expiration, leading to air trapping in the lungs and respiratory failure due to muscle fatigue.
• Recognizing respiratory distress in asthma patients involves observing the use of accessory muscles for breathing, the "tripod" position, and signs like chest flaring and nasal flaring, especially in children.