[Audio] Dental Office emergency - Pulmonary Edema. 

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[Audio] Pulmonary edema, also known as pulmonary congestion, occurs when there is an excessive accumulation of liquid in the tissue and air spaces of the lungs. It leads to impaired gas exchange and may cause hypoxemia and respiratory failure.. 

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Pulmonary edema, also known as pulmonary congestion, occurs when there is an excessive accumulation of liquid in the tissue and air spaces (usually alveoli) of the lungs. It leads to impaired gas exchange and may cause hypoxemia and respiratory failure.

Pulmonary Edema
Edema
fluid
Pulmonary Edema
Bronchiole
Alveoli
(air sacs)
Normal alveoli
Air
space
Blood capillary
Cleveland
Clinic
02021

[Audio] CARDIOGENIC PULMONARY EDEMA is the most common type of Pulmonary Edema and is the result of failure of the left ventricle of the heart to adequately remove oxygenated blood from pulmonary circulation. When a diseased or overworked left lower heart chamber ( left ventricle) can't pump out enough of the blood it gets from the lungs, pressures in the heart go up. The increased pressure pushes fluid through the blood vessel walls into the air sacs of the lungs.. 

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CARDIOGENIC PULMONARY EDEMA  is the  most common type of Pulmonary Edema and is the result of failure of the left ventricle of the heart to adequately  remove oxygenated blood from pulmonary circulation ( Congestive Heart Failure ) When a diseased or overworked left lower heart chamber (left ventricle) can't pump out enough of the blood it gets from the lungs, pressures in the heart go up. The increased pressure  pushes fluid through the blood vessel walls into the air sacs of the lungs .

[Audio] NON-CARDIOGENIC PULMONARY EDEMA is the result of direct injury to the tissue and blood vessels of the lung. Etiology of noncardiogenic pulmonary edema include: Acute respiratory distress syndrome ( ARDS), Drug reaction or drug overdose, Blood clot in the lungs ( pulmonary embolism), Exposure to certain toxins, High altitudes, Near drowning, Negative pressure pulmonary edema, Nervous system conditions or surgeries, Smoke inhalation, Transfusion-related lung injury, and Viral illnesses,. 

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NON-CARDIOGENIC PULMONARY EDEMA  is the result of  direct injury to the tissue and blood vessels of the lung. Etiology of n oncardiogenic pulmonary edema include:

Acute respiratory distress syndrome (ARDS) Drug reaction or drug overdose Blood clot in the lungs (pulmonary embolism) Exposure to certain toxins High altitudes Near drowning Negative pressure pulmonary edema Nervous system conditions or surgeries Smoke inhalation Transfusion-related lung injury Viral illnesses

[Audio] ACUTE PULMONARY EDEMA will result in a dental office emergency. The following factors can precipitate acute pulmonary edema in a dental office setting. Pre-existing conditions such a congestive heart failure, failure to take medications as prescribed, coupled with anxiety about the procedure and being placed in a supine position can trigger acute pulmonary edema. Reviewing the patient's medical history and checking their vital signs are critical steps in avoiding office emergencies.. 

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ACUTE PULMONARY EDEMA  will result in a dental office emergency.  Pre-existing conditions (congestive heart failure)  failure to take medications as prescribed,  coupled with anxiety about the procedure and being placed in a supine position  can trigger acute pulmonary edema. Reviewing the patient's medical history and checking their vital signs are critical steps.

[Audio] ACUTE PULMONARY EDEMA It is a swift and abrupt accumulation of fluid in the lungs, prohibiting lung expansion/ blood oxygenation. Signs and symptoms of acute pulmonary edema include: A Sudden, extreme shortness of breath, Trouble breathing or a feeling of suffocating (also known as dyspnea),
A bubbly, wheezing or gasping sound when breathing,
Coughing up phlegm that looks frothy/ pink or has blood in it, Cold sweat, clammy skin or a blue or gray color to the skin (also known as cyanosis) Anxiety, restlessness or Confusion,
A drastic drop in blood pressure that causes lightheadedness, dizziness, weakness or sweating
Or A sudden worsening of any of pulmonary edema symptoms. 

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ACUTE PULMONARY EDEMA  It is a  swift and abrupt accumulation of fluid in the lungs , prohibiting lung expansion/ blood oxygenation.  Signs and symptoms include:  Sudden, extreme shortness of breath Trouble breathing or a feeling of suffocating (dyspnea) A bubbly, wheezing or gasping sound when breathing Coughing up phlegm that looks frothy/ pink or has blood in it Cold sweat, clammy skin or a blue or gray color to the skin (cyanosis)  Anxiety, restlessness or Confusion A drastic drop in blood pressure that causes lightheadedness, dizziness, weakness or sweating A sudden worsening of any of pulmonary edema symptoms

[Audio] ACUTE PULMONARY EDEMA is life-threatening. If a patient begins to experience acute pulmonary edema during their appointment, the practitioner must halt treatment immediately, remove all instruments form the patient's mouth and call 911. Adjust the patient to a more comfortable semi-supine or upright position. Administer oxygen at a rate of 10 Liters per minute via a non breather bag. If the patient complains of suffocation, a nasal canula may be used at 2 to 5 Liters per minute. Their Vital signs including Blood Pressure, pulse, and respiration rate should be taken every 5 minutes and recorded Cardiogenic acute pulmonary edema may be alleviated by administering Nitroglycerine, which is a vasodilator. Two or three does of 0.8 to 1.2 milligrams every 5- 10 minutes can be given to the patient EXCEPT when their systolic Blood pressure is less than 100.
The practitioner can also help the patient to manage their apprehension or anxiety by exuding a calm, competent demeanor.. 

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ACUTE PULMONARY EDEMA  is life-threatening. Call 911!

Halt all dental treatment immediately and remove all instruments form the patient's mouth.  Adjust the patient to a more comfortable semi-supine or upright position. Administer oxygen at a rate of 10  L or more per minute via a non breather bag, if patient complains of suffocation, a nasal canula may be substituted and 2-5 L per minute.  Vital signs (BP, pulse, respiration rate) should be taken every 5 minutes and recorded  Cardiogenic acute pulmonary edema may be alleviated by administering Nitroglycerine (vasodilator) .0.8 – 1.2 mg every 5-10 minutes (2-3 doses) EXCEPT when the systolic BP < 100mmHg.    Help the patient to manage their apprehension/ anxiety  by exuding a calm, competent demeanor.

[Audio] In the rare event that the person experiencing acute pulmonary edema loses consciousness, maintaining an open airway and breathing is the primary concern. The person should be placed in a supine position, and basic life support administered. A person experiencing acute pulmonary edema will require hospitalization to manage the emergency. 

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In the rare event that the person suffering from  acute pulmonary edema  loses consciousness, maintaining airway/ breathing is the primary concern.  The person should be placed in a supine position, and basic life support (C-A-B) administered.  A person experiencing acute pulmonary edema will require hospitalization to manage the emergency

Call
immediately!
Position your
shoulders directly
over yotr hands,
and keep your
arms straight.
Place the heel of one
hand on the center of
the chest.
Place the heel of the
other hand on top of
the first hand, then lace
your fingers together.
Push hard and fast at the
rate of 100 beats per minute.
Try pushing to the beat of
the song, Staying Alive."
Use your body weight to help you
admhlster compressions that are 2
Inches deep.
Continue administering compressions until the
person begins to breath normally or until other
help or EMS arrives.

[Audio] Special thanks to Taylen Cameron, Sara Crow and Michelle Dukeman. 

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Grimes, Ellen B.  Medical Emergencies Essentials for Dental Professionals, 2 nd  Edition . 2014 Pearson Education Inc. Iredell Health System:  Don’t be a Bystander! Learn the Simple Steps of Hands-Only CPR  July 16, 2021  https://www.iredellhealth.org/news/releases/don-t-be-a-bystander-learn-the-simple-steps-of-hands-only-cpr/   The Mayo Clinic:  Pulmonary edema , May 27, 2022 https://www.mayoclinic.org/diseases-conditions/pulmonary-edema/symptoms-causes/syc-20377009 The Cleveland Clinic:  Pulmonary Edema , 2022  https://my.clevelandclinic.org/health/diseases/24218-pulmonary-edema   Special thanks to  Taylen  Cameron, Sara Crow and Michelle Dukeman Ju

Pulmonary Edema

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Dental Office emergency  - Pulmonary Edema

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Pulmonary edema, also known as pulmonary congestion, occurs when there is an excessive accumulation of liquid in the tissue and air spaces of the lungs

It leads to impaired gas exchange and may cause hypoxemia and respiratory failure.

CARDIOGENIC PULMONARY EDEMA is the most common type of Pulmonary Edema and is the result of failure of the left ventricle of the heart to adequately  remove oxygenated blood from pulmonary circulation

When a diseased or overworked left lower heart chamber (left ventricle) can't pump out enough of the blood it gets from the lungs, pressures in the heart go up

The increased pressure pushes fluid through the blood vessel walls into the air sacs of the lungs.

NON-CARDIOGENIC PULMONARY EDEMA is the result of direct injury to the tissue and blood vessels of the lung

Etiology of noncardiogenic pulmonary edema include:

Acute respiratory distress syndrome (ARDS),

Blood clot in the lungs (pulmonary embolism),

ACUTE PULMONARY EDEMA will result in a dental office emergency

The following factors can precipitate acute pulmonary edema in a dental office setting

Pre-existing conditions such a congestive heart failure, failure to take medications as prescribed, coupled with anxiety about the procedure and being placed in a supine position can trigger acute pulmonary edema.

Reviewing the patient's medical history and checking their vital signs are critical steps in avoiding office emergencies.

ACUTE PULMONARY EDEMA It is a swift and abrupt accumulation of fluid in the lungs, prohibiting lung expansion/ blood oxygenation

Signs and symptoms of acute pulmonary edema include

Trouble breathing or a feeling of suffocating (also known as dyspnea),

A bubbly, wheezing or gasping sound when breathing,

Coughing up phlegm that looks frothy/ pink or has blood in it,

Cold sweat, clammy skin or a blue or gray color to the skin (also known as cyanosis)

A drastic drop in blood pressure that causes lightheadedness, dizziness, weakness or sweating

Or A sudden worsening of any of pulmonary edema symptoms

ACUTE PULMONARY EDEMA is life-threatening

If a patient begins to experience acute pulmonary edema during their appointment, the practitioner must halt treatment immediately, remove all instruments form the patient's mouth and call 911

Adjust the patient to a more comfortable semi-supine or upright position

Administer oxygen at a rate of 10  Liters per minute via a non breather bag

If  the patient complains of suffocation, a nasal canula may be used at 2 to 5 Liters per minute

Their Vital signs including Blood Pressure, pulse, and respiration rate should be taken every 5 minutes and recorded

Cardiogenic acute pulmonary edema may be alleviated by administering Nitroglycerine, which is a vasodilator

Two or three does of 0.8 to  1.2 milligrams  every 5-10 minutes  can be given to the patient EXCEPT when their systolic Blood pressure is less than 100.

The practitioner can also help the patient to manage their apprehension or anxiety  by exuding a calm, competent demeanor.

In the rare event that the person experiencing acute pulmonary edema loses consciousness, maintaining an open airway and breathing is the primary concern

The person should be placed in a supine position, and basic life support administered

A person experiencing acute pulmonary edema will require hospitalization to manage the emergency

Special thanks to Taylen Cameron, Sara Crow and Michelle Dukeman

 Grimes, Ellen B.  Medical Emergencies Essentials for Dental Professionals, 2 nd  Edition . 2014 Pearson Education Inc. Iredell Health System:  Don’t be a Bystander! Learn the Simple Steps of Hands-Only CPR  July 16, 2021  https://www.iredellhealth.org/news/releases/don-t-be-a-bystander-learn-the-simple-steps-of-hands-only-cpr/   The Mayo Clinic:  Pulmonary edema , May 27, 2022 https://www.mayoclinic.org/diseases-conditions/pulmonary-edema/symptoms-causes/syc-20377009 The Cleveland Clinic:  Pulmonary Edema , 2022  https://my.clevelandclinic.org/health/diseases/24218-pulmonary-edema   Special thanks to  Taylen  Cameron, Sara Crow and Michelle Dukeman Ju