Dental Emergencies

Sudden temporary loss of consciousness; faint

unconsciousness; no arousal

Total lack of O2

Reduced supply of O2

• Inadequate cerebral circulation
• O2 deprivation
• Changes in Blood Quality
• Psychological changes
• CNS changes
• Poor physical condition
• Sign of underlying condition
• May be associated with Stress

• Reduces blood to the brain which cause reduced O2 to the brain
• It is the Most Common Mechanism of unsciousness
• <30ml blood/100g brain tissue

• Brain needs Glucose & O2
• 65% glucose intake & 20% O2 intake
• 20% total blood circulation must reach the brain every minute.

• Hypoglycemia
• Hyperglycemia
• Allergic reactions
• Hyperventilation
• Drugs

• Seizsures
• CVA (stroke)

• Management for unconsciousness
• Position
• Airway
• Breathing
• Circulation
• Definitive Management

• 22-40 brpm
• N=10-16 brpm
• Increased PaO2 and decreased PaCO2
• Ages:15-40

Arterial O2 blood gas level

Arterial CO2 blood gas level

• Abnormally low PaCO2 level
• N=40mmHg
• Hypocapnia=25-30mmHg

Increased blood pH level

• High altitudes
• Stress/anxiety
• Pregnancy
• CNS stimulants

• NONINFECTIOUS
• -Obstructive Airway Diseases
• -Pulmonary Embolism
• -Myasthenia Gravis; autoimmune that effects breathing muscles
• INFECTIOUS
• -Pneumonia
• -Legionnaires Disease; fever and pneumonia
• -TB

• Reactive Airway Disease; recurring
• Difficulty breathing bc broncial constriction
• Increasing problem in children

• Cold Temps
• Respiratory infections
• exercise
• stress
• allergens/food
• drugs

• Extrinsic: allergic & IgE; most common (35% of adults and many children)
• -Drug Induced: ingestion
• Intrinsic: nonallergic; endogenous(from within a person; 30% of asthma cases)
• -Exercise Induced
• Infectious: inflammation from infection

Continuous asthma attack withhout relief caused by any classification and can be life threatening

• Smooth muscle around bronchial contracts
• Increased mucuos production causing bronchial plugging and dehydration
• Alveolar Hypoventilation
• Hypercapnia: CO2 retention

• Mild: stop, position, calm, self adminster bronchodilator, if relief resume treatment
• Severe: stop, position, calm, self adminster bronchodilator, O2 4-6L/min, No relief after inhalar 1mg Epi, still no relief call 911

• Chronic obstructive pulmonary disease
• Chronic Bronchitis
• Emphysema

• Prolonged exposure to irritants
• Excessive mucus secretions
• Hypercapnia
• Pulmonary hypertension
• Right ventricular hypertrophy

• Destruction of alveoli
• Decrease elasticity recoil (air trapping, hyperinflation)
• Increased expiration difficulty
• Thin appearance

• Amount of Allergen
• Rate of exposure
• Route of exposure

• Immediate hypersensitivity <60 mins
• Caused by IgE
• Acute; can be life threatening
• Generalized (anaphylaxis) or Local (hives etc..)

Cell death (Cytolytic)

Not IgE mediated, but have anaphylaxis type S&S (anaphylactoid reactions)

• Delayed hypersensitivity >12 hrs can take up to 48 hrs
• May be difficult to diagnose cause of time frame
• inflammation develops
• generalized or local

• First exposure
• substance enters the body and antibodies are produced
• no reactions this time

• Later Exposure
• Mast cells and Basophils undergo degranlation
• Body over reacts
• Histamine is released
• The quicker the reaction the more severe it is

• Relaxes vascular smooth muscle
• Contracts nonvascular smooth muscle like GI and uterus

• Hives
• Itch and painful
• Caused by contact or ingestion

• Localized non-inflammatory swelling from an allergy
• facial, tongue, throat

• Epinephrine
• Antihistamines
• Steroids