©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Asthma Chapter 8

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Introduction Diseases or problems associated with the respiratory system –Asthma attacks are one type of emergency seen in a dental office –Asthma is a disease of the respiratory tract that can affect all aspects of the tracheobronchial tree: trachea, bronchi, and bronchioles Affects a large part of the population 2

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types Extrinsic asthma (allergic asthma): –Most common type of asthma in children and young adults and can be outgrown Usually do not exhibit any signs or symptoms of asthma between episodes 3

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types –Triggered by exposure to allergen or exercise induced –Dental team needs to be aware of any allergens that trigger a patient’s asthma 4

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types (cont’d.) Emergency Basics Box 8-1: Common Allergens in the Dental Office 5

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types Intrinsic asthma (infectious asthma): –Most often seen in adults older than 35 –Usually occurs as a result of a bronchial infection –Patient may exhibit a chronic cough with sputum production between attacks 6

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Types (cont’d.) Status asthmaticus –Most severe type that does not respond to normal drug therapy –Patient needs to be hospitalized 7

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Causes Asthma attacks can be triggered by many causes –Allergens –Anxiety or emotional upset is the main cause of attacks in the dental office 8

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Causes –For prevention, it is important for staff to: Not keep the patient waiting for an extended period Explain and demonstrate procedures/equipment Not use threatening terminology (shot) 9

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Symptoms Can occur quickly or over a period of time Must distinguish between asthma attack and airway obstruction –With an airway obstruction: stridor (constant pitch musical sound) –With asthma: wheezing 10

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Symptoms –If a patient has indicated a history of asthma, the attack should be treated as asthma Patient will appear to be struggling for air –May be sweating, coughing, or nervous –May complain of severe tightness in chest 11

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Symptoms Duration varies –Attack can end quickly if the patient is treated with a bronchodilator –Status asthmaticus does not respond to medication and the patient should be hospitalized 12

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Stop all dental treatment –Remove all materials and instruments from the patient’s mouth Position the patient upright –Patient can breathe easier if seated upright 13

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment Use a bronchodilator –While reviewing the health history, dental auxiliary should ask if the patient uses a bronchodilator Administer oxygen –Administer four to six liters of oxygen per minute by a full-face mask or nasal canula –Have the patient hold the mask 14

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment If the bronchodilator does not relieve the attack, the dentist may have to administer epinephrine If treatment is unsuccessful, call EMS 15

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Treatment for Asthma Emergency Basics Box 8-3 Treatment for Asthma 16

©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Summary Asthma attacks in the dental office are most often triggered by anxiety Particularly important to keep patients with asthma calm during dental treatment Should an asthma attack occur, administer treatment promptly 17