DAANCE- Module 5- Office Anesthesia Emergencies

DAANCE- Module 5- Office Anesthesia Emergencies Mallampti Classification - Visual analysis of the oral/oropharyngeal anatomy Mallampti Class I - Visualization of the soft palate, fauces, uvula, anterior and posterior pillars Mallampti Class II - Visualization of the soft palate, fauces, and uvula Mallampti Class III - Visualization of the soft palate and the base of the uvula Mallampti Class IV - Soft palate is not visible at all. Signs of Airway Obstruction - Choking, gagging, substernal notch retraction, labored breathing, rapid pulse initially, then decreased pulse, respiratory arrest, and cardiac arrest Treatment of Airway Obstruction - Early Treatment: 100% O2 via nasal mask, trendelenburg position (pack of surgical site), digital traction of tongue (with gauze, tongue forceps, hemostat, or sutures), suctioning of the oropharynx. Advanced Treatment: Abdominal thrusts, laryngoscopy, cricothrotomy. Larygospasm- what is it, and what can a partial or complete closure result in? - Protective reflex of the vocal cords that attempts to stop foreign matter getting into the larynx, trachea, and lungs. Partial or complete closure of the vocal cords can occur resulting in airway obstruction. Treatment of Laryngospasm - 100% O2 via nasal hood, maintain/establish airway, pack off surgical site, suction of oral cavity and oropharynx, positive pressure, 100% oxygen via bag/mask system, succinylcholine (Deepening the level of anesthesia may also help) Bronchospasm - Generalized contraction of the smooth muscles of the small bronchi and bronchioles of the lungs, resulting in restriction of airflow to and from the lungs. Patient will have more difficulty with expiration than inspiration. Patients more susceptible to bronchospasm - Patients with history of allergies, asthma, COPD, and bronchitis Diagnosis of Bronchospasm - Labored breathing, aspirational difficulty, signs of diminishing respiratory status (cyanosis or decreased ventilation patterns on capnograph) Treatment of Bronchospasm - 100% Oxygen via bag/mask, albuterol, atrovent, epinephrine injection, intubation/ventilation, steroid injection, diphenhydramine, aminophylline. (Activate EMS after steroid injection if it has not been resolved) Aspiration - Occurs when the contents of the stomach enter the lungs secondary to emesis, or when a foreign body or fluid inadvertently enters the lungs from the oral pharyngeal cavity through the larynx. Treatment of Emesis with Aspiration - Activate EMS, 100% O2 via bag/mask, turn patient on right side with head down (trendelenburg position), tonsil suction, removal of visible foreign bodies, intubation, transport to acute care facility Hyperventilation - Occurs when the patient is breathing at a rate faster than his/her normal breathing pattern or brea