StreamDent

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All Emergencies - Basic life support principles:

  1. Maintain an airway
  2. Assess breathing
  3. Monitor circulation
Monitor and record all vital signs.
Respiratory Depression

Signs/symptoms:

  1. Often secondary to administration of CNS depressant drugs
  2. Decreased rate of respiration &/or decreased ventilatory effort

 

Management:

  1. Terminate dental treatment.
  2. Place patient in supine position.
  3. A-B-C Airway, Breathing, Circulation - Basic life support, as indicated.
  4. Monitor BP, heart rate & rhythm every 5 minutes.
  5. Administer oxygen.
  6. Start IV infusion if not already present.
  7. Antidotal drugs can be used, though not usually necessary:
    • When opioids have been administered, give naloxone - adults - 0.1 mg/min until improved ventilation noted.
    • When benzodiazepines have been administered, give flumazenil - adults - 0.2 mg/min until improved ventilation is seen.
    • When barbiturates have been administered, no antagonist exists. Continue assisted ventilation until spontaneous breathing returns.
  8. Recovery: It may be possible to continue dental treatment if respiratory depression was brief. If problem was prolonged, it may be necessary to end planned treatment.
  9. Discharge the patient to a responsible adult if the doctor believes patient's recovery is adequate. Outside medical assistance rarely required.

Source: Sedation, A Guide to Patient Management by Stanley F. Malamed













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