7. GENERAL Management
1-recognition of respiratory distress
2-terminate dent proc
3-p: depend on patient
some feels better on upright post
if patient is unconsc………supine position
4-A, B,C
5-definitive care
monitor vital signs
ttt of anxiety
Ttt pf respiratory problems
8.
9. AIRWAY OBSTRUCTION
CAUSES:
Foreign body……meat….large, alcohol, talk
In dent a foreign body--Oral c ---- -pharynx-- > -RESP TR------as ex
hand piece, head of mouth mirror
;gold crowns
Congenital defects of airway
Infections : epiglottitis , tonsillitis , Ludwig’s angina
Trauma
Tumors
11. prevention
when Objects- usually …> G I T…….
complications
rare-- bronchi ---respir complications
TO AVOID ASPIRATION & RESP COMP
MANY MEASURES CAN BE USED
A)RUBBER DAM
B)ORAL PACKING
C)POSITION
D) assistant care
E) suction, Magill intubation forceps
F) ligature
17. Management of airway obstruc
N B important general points……
If object falls in air passage don’t allow the
patient to sit up
recline the chair backwards….
do X –ray for chest & abdomen
put him in left lateral decubitus position
with head down
encourage coughing
If object still not removed -emergency
fibroptic bronchoscope
If failed --------thoracotomy
19. Management of airway obstruc
R-recognition of airway obst
see if complete airway obst or incomplete
COMPLETE airway obst :
sign of compl airway obst
inability to speak
inability to breathe
inability to cough
universal sign for choking
22. If obst is relieved in 4-5 min ----normal
after 2-5m-----loss of consc
More 4------blood pr & pulse
disappear
23. sign
of partial airway obst
Forceful cough
Wheezing
Crowing sound on inspiration
With more obst
absent voice sounds
Cyanosis
Lethargy
disorientation
24.
25. After R-recognition of airway obst
T-terminate dental ttt
P-supine … feet slightly elevated
A B C ……>>>>>
BASIC AIRWAY MANEUVERS
26. BASIC AIRWAY MANEUVERS
B L S
A- Air way opening by... head tilt-chin lift …
This will open the airway obst… if tongue
is the cause of the obstruction ….
Or do jaw thrust maneuver if ……
B- Breathing care by…
look listen &feel technique …..
in which rescuer put his ear near mouth &
nose of patient & listens &feels for air exchange
and if airway is still obstructed
30. this may be due to foreign body ……………
***Try to remove this foreign body by
- abdominal thrust [ Heimlich],
chest thrust
back blow,
finger sweep
****-if failed above & the object is at higher
level …….> do emergency airway opening
by a-tracheostomy
b- cricothyrotomy
43. Hyperventilation
Means excess ventil more than required to maintain
Pa O2 & PaCO2
there may be increase in rate of resp or depth or both
Causes
-pain………stress
-acidosis
-drugs
Hypercapnea
Cirrhosis
CNS disorders
44.
45. Signs & symptoms
C V S: palpitation, tachycardia , pain
CNS : dizziness , disturbed consc or
vision
RESPIR : short [ may in stress conditions]
rapid breath, pain
GIT
: pain
Musc : tremors, carpopedal tetany,
stiffness
PSYCHIC :tension, anxiety
47. management
1-R
2 -terminate dent proc….. remove dental materials
3-p MAY in upright posit to help respiration
4-A, B,C
7-definitive care
calm patient…….. Drug as diazepam
ttt resp alkalosis
48. ASTHMA
Defin : paroxysmal attacks of difficult
breathing ,tightness,& impending
suffocation without fever……
Commoner in young people
Cause
may allergy
respir infections
physical exertion
49. types
I-----Extrinsic asthma [allergic ]
more in children….
allergens ---- type I hypersensitivity
II------intrinsic asthma [ non allergic ]
more in olders….
resp infect -develop of sympt
III------Mixed asthma : involved I & II
IV-----Status asthmaticus: not respond to 2-3
doses of B- adrenergic drugs