airway obstruction with foreign bodies treatment in dental office
TRANSCRIPT
AIRWAY OBSTRUCTION
Trauma foreign bodies
inflammation
hematomas
CNS disease secretions
Drug overdose
Infections glottitis
Obstructive sleep apnea
ETIOLOGY IN DAILY LIFE
They lack molars for proper grinding of food.
They tend to be running or playing at the time of aspiration.
They tend to put objects in their mouth more frequently.
They lack coordination of swallowing and glottis closure.
Curiosity, boredom
ASPIRATION - PREVENTION
Most Objects Enter GI Tract
Epiglottis Seals Trachea
Use Rubber Dam
Use Posterior Oral Packing
Suction/Assistant
Magill Forceps
FOREIGN BODY ASPIRATION/INGESTION
Can Be Critical
Good chance of Retrieval If PtConscious
Small Items May Pass Through Trachea
3000/year Die From Airway Obstruction
Most Common Item Is Food
SWALLOWED OBJECTS
Keep Patient Supine??
Magill Forceps
Head Down Position
If Unable to Visualize……….
ASPIRATED OBJECTS
Airway Obstruction - Partial/Complete
Level of Obstruction
Place Patient in Right Lateral Decubitus
Encourage Cough
Be Alert to Airway Obstruction
SITE OF LODGING OF FOREIGN BODY RIGHT
MAIN BRONCHUS
The diameter of the right main bronchus is larger than the left,
The angle of divergence from the tracheal axis is smaller on the right,
Airflow through the right lung is greater than through the left,
The carina is more likely to be located to the left of midline rather than to the right.
FOREIGN BODY ASPIRATION
Complete airway obstruction
Choking sign
Respiratory distress
Inability to speak or cough
Partial airway obstruction
Coughing
Gagging
Throat clearing
Back blows/robipng hypopharynx not
recommended
TREATMENT
Back blows
Is not common for adult and children
Heimlich maneuver
Chest thrust
Finger sweep
COMPLETE AIRWAY OBSTRUCTION
MANAGEMENT
< one year
Back blows and chest thrust….. NEVER perform an abdominal thrust on an infant
> one year
Gentle abdominal thrusts while supine
Older children/adults
Heimlich maneuver(abdominal thrust)
IF YOUR PATIENT IS UNCONSCIOUS…
BLS(Base Life Support);
Supine position
Head tilt chin lift
Look & listen & feel
Jaw thrust
Heimlich maneuver
Finger sweep
Chest thrust
TREATMENT OF INFANTS
Infants under 1 year of age:
A combination of 5 back blows (with the flat of the hand) and 5 abdominal thrusts (with 2 fingers on the upper abdomen).
SUBDIAPHRAGMATIC ABDOMINAL THRUST
(THE HEIMLICH MANEUVER) ADMINISTERED TO A
CONSCIOUS (STANDING) VICTIM OF FOREIGN BODY
AIRWAY OBSTRUCTION.
SUBDIAPHRAGMATIC ABDOMINAL THRUST (THE
HEIMLICH MANEUVER) ADMINISTERED TO AN
UNCONSCIOUS (LYING) VICTIM OF FOREIGN BODY
AIRWAY OBSTRUCTION - ASTRIDE POSITION