Feeling of chest tightness Dyspnea Tachypnea Cough Use of Accessory/Respiratory Muscles Agitations WHEEZING
ALL THAT WHEEZES IS NOT ASTHMADifferential Diagnosis: Pulmonary Edema Pulmonary Embolism Anaphylactic Rxn COPD Pneumonia Foreign Body Aspiration Cystic fibrosis
History & Clinical Chest X- Ray (CXR) Pulmonary Function Test (PFT) Arterial Blood Gases (ABGs)
Dental treatment may lead to anxiety of patient this lead to bronchi construction..And if not treated immediately it may lead to a condition called status asthmaticus,, it consider as sever form of paroxysmal asthma and consider as live threat
Frequency of asthmatic attacks Precipitating agents Types of pharmacotherapy used Length of time since an emergency visit owing to acute asthma
1.Patients appointment should be late morning or afternoon.2.Assess severity of ASTHAMATIC condition.3.Consider antibiotic prophylaxis for immuno- suppressed patients4.Consider corticosteriod replacement for adrenally suppressed patients.
Confirm that they have taken their most recent scheduled dose of medication. The patient’s own metered-dose inhaler bronchodilator should be on hand at each visit to minimize the risk of an attack. Procedure should be done Late morning / afternoon. Emergency kit with a bronchodilator and oxygen.
Avoid using dental materials that may elicit an ASTHMATIC ATTACK ie ,DENTIFRICES ,FISSURE SEALANTS ,METHYL METHA ACRYLATE ,FLOURIDE TRAYS & COTTON ROLLS can trigger asthmatic events. Ifasthmatic patients does not use a broncodilator ,make sure the emergency kits has both a bronchodilator & oxygen.
1.Rubber dams should be used cautiously.2.Use technique to reduce patient stress: Avoid prolonged supine positioning Avoid nitrous oxide in people with sever ASTHMA. Avoid using BARBITURATES.3.Avoid using LA containing SODIUM METABISULFIDE. 4.Use vasoconstrictor judiciously
1.TETRACYCLINE should be used cautiously.2.Avoid use of ERTHROMYCIN in patients taking THEOPHYLLINE.3.Avoid use of PHENOBARBITALS in patients taking THEOPHYLLINE.4.Analgesic of choice for these patients is ACETAMINOPHEN.
During and immediately after local anesthetic administration. Withstimulating procedures such as extraction, surgery,pulp extirpation
You gave local anesthesia to your patient & all of a sudden patient: Has difficulty in breathing Talking in phrases You could hear loud wheezes Using accessory muscles Slightly Agitated
Discontinue the dental procedure and allow the patient to assume a comfortable position. Establish and maintain a patent airway and administer b2 agonists via inhaler or nebulizer. Administer oxygen 6-10 liters via face mask, nasal hood or cannula. If no improvement is observed and symptoms are worsening, administer epinephrine subcutaneously (1:1,000 solution, 0.01 milligram/ kilogram of body weight to a maximum dose of 0.3 mg).
Document in time form the beginning of the event. Alert emergency medical services. Maintaina good oxygen level until the patient stops wheezing and/or medical assistance arrives. Begin diligent basic life support. Escort patient to hospital as needed.