Comprehensive Airway and Emergency Management in Dentistry: Definitions, Signs, and Procedures

What is the objective of airway obstruction management?

Recognize and identify management of airway obstruction.

What are ways to prevent airway emergencies in dentistry?

Observe body language, use rubber dam, fasten equipment tightly, proper chair/head position, keep patient upright for impressions, use high-volume suction, use gauze partition, attach floss to products.

What is respiration?

The process of gas exchange where the body gains oxygen and loses carbon dioxide.

What is alveolar ventilation?

Volume of air exchanged per minute.

What is a torr?

A unit of pressure equal to 1 mm Hg.

What is normal PaCO2?

35-45 torr.

What is normal PaO2?

75-100 torr.

What is anoxia?

Absence of oxygen.

What is apnea?

Absence of respiratory movement.

What is dyspnea?

Difficulty breathing or 'air hunger.'

What is hyperpnea?

Increased ventilation that meets metabolic demands.

What is hyperventilation?

Ventilation exceeding metabolic demands; PaCO2 less than 35 torr.

What is hypoventilation?

Ventilation that does not meet metabolic demands; PaCO2 greater than 45 torr.

What is tachypnea?

Increased respiratory rate.

What does CPR stand for?

Cardiopulmonary Resuscitation.

What is EMS?

Emergency Medical System.

What is respiratory arrest?

Sudden cessation of breathing.

What is cardiac arrest?

Sudden cessation of heartbeat and circulation.

What is clinical death?

Reversible cessation of heart activity.

What is biologic death?

Permanent cellular damage.

What is airway obstruction?

Partial or complete blockage of the airway preventing adequate air exchange.

What can cause airway obstruction in dentistry?

Dental materials, food, balloons, marbles, toys.

What are signs of mild airway obstruction?

Forceful coughing.

What is the management of mild airway obstruction?

Encourage coughing and deep breathing.

What are signs of severe airway obstruction?

Weak/no cough, inability to speak or breathe, clutching neck.

What are progression signs of severe obstruction?

Cyanosis, panic, increased heart rate, unconsciousness within about 2 minutes.

What should happen immediately during a dental emergency?

Stop dental treatment.

What is the preferred conscious patient positioning during emergencies?

Upright or Semi-Fowler's position.

What is Semi-Fowler's position?

Semi-upright position with head/back at 30-45 degrees.

What is the conscious choking treatment for adults and children?

5 back blows and 5 abdominal thrusts (Heimlich).

What is used instead of abdominal thrusts for pregnant or obese patients?

Chest thrusts.

What is the choking management for infants?

5 back blows and 5 chest thrusts.

When should choking intervention stop?

When the object is removed or patient becomes unconscious.

What is the first step for an unconscious choking patient?

Call EMS.

What is the proper positioning for an unconscious patient?

Supine with head lower than throat.

What does A-B-C stand for?

Airway, Breathing, Circulation

How long should a pulse check last?

Less than 5 seconds.

What is the purpose of head tilt-chin lift?

Moves tongue off airway to clear airway.

When should head tilt-chin lift NOT be used?

Patients with cervical spine issues.

Should blind finger sweeps be used?

No.

What does jaw thrust do?

Moves jaw and tongue forward to clear airway.

What can jaw thrust help break?

Laryngospasm.

What should be started for an unconscious patient?

CPR or rescue breathing.

What is the recommended oxygen administration during emergency?

10-15 liters/minute.

What should be monitored during emergency care?

Vital signs.

Why roll an unconscious patient to the side?

Help maintain airway and drainage.

What is rescue breathing used for?

Patient has pulse but labored breathing.

How often should rescue breaths be given?

Every 5-6 seconds.

What are methods of rescue breathing?

Mouth-to-mouth, mouth-to-barrier, bag-mask.

What does a bag-valve mask do?

Provides mechanical ventilation to an apneic patient.

What is another use of a bag-valve mask?

Can break laryngospasm.

What must be avoided during BVM ventilation?

Inflating the patient's stomach.

What are requirements for successful BVM ventilation?

Open airway, good seal, proper positioning, proper technique.

What equipment is included in a portable oxygen unit?

Oxygen tank, regulator, tubing, resus bag/mask or demand valve.

If a foreign body is not recovered, what should happen?

Refer patient for radiographic localization.

What may be needed after airway foreign body aspiration?

Follow-up radiographs or surgery.

What are causes of overdose-related breathing difficulty?

Local anesthesia, sedatives, opioids.

What does LAST stand for?

Local Anesthetic Systemic Toxicity.

What is the most common cause of LAST?

Accidental intravascular injection.

What are initial symptoms of LAST?

Agitation, confusion, dizziness, tinnitus, metallic taste, numbness.

What is the severe progression of LAST?

Seizures, respiratory arrest, coma.

What is the initial management focus for LAST?

Airway management.

What is naloxone?

Medication that rapidly reverses opioid overdose.

How does naloxone work?

Blocks and reverses opioid effects at opioid receptors.

What are examples of opioids reversed by naloxone?

Heroin, fentanyl, oxycodone, hydrocodone, codeine, morphine.

What does naloxone restore during overdose?

Normal breathing.

Does naloxone affect people without opioids in their system?

No.

Why can awake patients help in airway emergencies?

They can protect their own airway.

Why are conscious patients helpful during choking emergencies?

They can assist with coughing and positioning.

What should you never hesitate to do during emergencies?

Call for help or activate EMS.

What happens during respiratory arrest?

Breathing ceases.

What happens during cardiac arrest?

Heart stops beating.

What are the outcomes of untreated respiratory distress?

Respiratory arrest → cardiac arrest → death.