Office Anesthesia Emergencies Flashcards

The initial management of a dental patient experiencing an acute asthmatic attack unresponsive to their own rescue inhaler is:

Answer: Administer epinephrine 0.3 mg IM and activate EMS if severe

Severe bronchospasm unresponsive to beta-2 agonist inhaler requires epinephrine IM and EMS activation, as the patient may be progressing to status asthmaticus.

Laryngospasm is BEST distinguished from bronchospasm during sedation by:

Answer: High-pitched inspiratory stridor and complete or partial upper airway closure

Laryngospasm typically presents with high-pitched inspiratory stridor (partial) or silent chest with no airflow (complete closure) - an upper airway finding, unlike the expiratory wheeze of bronchospasm.

During IV sedation, a patient develops lip swelling, urticaria, and wheezing 10 minutes after cefazolin administration. The FIRST drug to administer is:

Answer: Epinephrine 0.3 mg IM (1:1000)

The clinical picture (urticaria plus angioedema plus bronchospasm after antibiotic) is anaphylaxis. Epinephrine IM is the FIRST and most critical intervention.

A patient develops a vasovagal syncope episode during local anesthetic injection. The FIRST action is:

Answer: Place the patient in Trendelenburg position (supine with legs elevated)

Trendelenburg positioning restores cerebral perfusion by increasing venous return to the heart. This, combined with discontinuing the procedure, resolves most vasovagal episodes.

A patient with known coronary artery disease develops chest tightness and diaphoresis during dental sedation. After positioning and administering supplemental oxygen, the NEXT priority is:

Answer: Activating EMS and administering aspirin 325 mg chewable if not contraindicated

Suspected AMI requires immediate EMS activation, aspirin administration, and nitroglycerin if appropriate. Do not delay EMS to wait and see.

Which maneuver is MOST effective for initial management of an obstructed airway in an unconscious patient with a foreign body above the glottis?

Answer: Head-tilt-chin-lift followed by direct visualization and manual removal if visible

Head-tilt-chin-lift opens the airway, and if the foreign body is visible on direct inspection, manual removal is attempted. Blind finger sweeps may push the object deeper.