Chapter 15
Management of Emergencies Associated with Pediatric Dental Sedation
Kenneth L. Reed,
Amanda Jo Okundaye,
Kenneth L. Reed
Search for more papers by this authorAmanda Jo Okundaye
Search for more papers by this authorKenneth L. Reed,
Amanda Jo Okundaye,
Kenneth L. Reed
Search for more papers by this authorAmanda Jo Okundaye
Search for more papers by this authorBook Editor(s):Gerald Z. Wright,
Ari Kupietzky,
Gerald Z. Wright
Search for more papers by this authorAri Kupietzky
Search for more papers by this authorFirst published: 24 January 2014
Summary
Medical emergencies, sometimes life-threatening, can and do occur in the pediatric dental office. The focus of this chapter is on the management of medical emergencies directly associated with pediatric sedation. The basic algorithm for the management of most medical emergencies is: (P) position, (A) airway, (B) breathing, (C) circulation, and (D) definitive care: differential diagnosis, drugs, defibrillation. The algorithm is discussed in detail in the chapter, as it relates to pediatric dental sedation. Children present the highest risk and lowest error tolerance in patient safety during sedation procedures. Familiarity with the patient's medical history is highly important in preventing medical emergencies. Management of medical emergencies in the dental office may be limited to supporting a patient's vital functions until emergency medical services (EMS) arrive, especially in the case of major morbidity.
References
- Adams, P.F. and Hendershot, G.E. (1996). Current estimates from the National Health Interview Survey, 1996. Vital and Health Statistics, 10, 200.
- Adewumi, A. and Kays D.W. (2008). Stainless steel crown aspiration during sedation in pediatric dentistry. Pediatric Dentistry, 30, 59–62.
- Akinbami, L.J. (2006). The State of Childhood Asthma, United States, 1980–2005. Advance data from Vital and Health Statistics , 381. Hyattsville, MD: National Center for Health Statistics.
- American Heart Association (2005a). Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 4: adult basic life support. Circulation, 112, IV-19–IV-34.
- American Heart Association (2005b). Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 11: pediatric basic life support. Circulation, 112, IV–156-IV-166, 13.
- Baker, S. and Yagiela, J.A. (2006). Obesity: a complicating factor for sedation in children. Pediatric Dentistry, 28, 487–493.
- Bennet, J. and Rosenberg, M.B. (2002). Medical Emergencies in Dentistry. W. B. Saunders. Philadelphia, PA, USA
- Black, R.E., Johnson D.G., Matlak M.E. (1994). Bronchoscopic removal of aspirated foreign bodies in children. Journal of Pediatric Surgery, 29, 682–684.
- Boyce, J.A. et al. (2010). Guidelines for the Diagnosis and Management of Food Allergy in the US: Summary of the NIAID-Sponsored Expert Panel. Journal of Allergy and Clinical Immunology, 126, 1105–1118.
- Brull, S.J. (2008). Lipid emulsion for the treatment of local anesthetic toxicity: patient safety implications. Anesthesia and Analgesia, 106, 1337–1339.
- Bryan, R.B. and Sullivan, S.M. (2006). Management of dental patients with seizure disorders. Dental Clinics of North America 50, 607–623.
- Cameron, S.M., Whitlock, W.L., Tabor, M.S. (1996). Foreign body aspiration in dentistry: a review. Journal of the American Dental Association, 127, 1224–1229.
- Chicka, M.C. et al. (2012). Adverse Events during Pediatric Dental Anesthesia and Sedation: A Review of Closed Malpractice Insurance Claims. Pediatric Dentistry, 34, 231–238.
- Ciftci, A.O. et al. (2003). Bronchoscopy for evaluation of foreign body aspiration in children. Journal of Pediatric Surgery, 38, 1170–1176.
- Desai, S.V. (2007). Natural rubber latex allergy and dental practice. New Zealand Dental Journal, 103, 101–107.
- Findler, M. et al. (2002). Syncope in the dental environment [in Hebrew]. Refuat Hapeh Vehashinayim, 19(1), 27–33, 99.
- Fukayama, H. and Yagiela, J.A. (2006). Monitoring of vital signs during dental care. International Dental Journal, 56, 102–108.
- Ganzberg, S.I. (2013). Medical emergencies. In: Pediatric dentistry infancy through adolescence (eds. P.S. Casamassimo, H.W. Fields, D.J. Mctigue, A.J. Nowak) 5th edn. 126–138. Elsevier Saunders, St Louis, Missouri.
-
Haas, D.A. (2010). Preparing dental office staff members for emergencies: developing a basic action plan. Journal of the American Dental Association, 141, 8 s–13 s.
10.14219/jada.archive.2010.0352 Google Scholar
- Hepner, D.L. and Castells, M.C. (2003). Anaphylaxis During the Perioperative Period. Anesthesia and Analgesia, 97, 1381–1395.
- Kang, J. et al. (2012). The safety of sedation for overweight/obese children in the dental setting. Pediatric Dentistry, 34, 392–396.
- Leith, R. et al. (2008). Aspiration of an avulsed primary incisor: a case report. Dental Traumatology, 24, e24-6. doi: 10.1111/j.1600-9657.2008.00593.x. Epub 2008 Jun 28.
- Lepere, A.J., Finn, J., Jacobs, I. (2003). Efficacy of cardiopulmonary resuscitation performed in a dental chair. Australian Dental Journal, 48, 244–247.
- Lieberman, P. et al. (2005). The diagnosis and management of anaphylaxis: An updated practice parameter. Journal of Allergy and Clinical Immunology, 115, S483–523.
- Malamed, S.F. (1993). Managing medical emergencies. Journal of the American Dental Association, 124, 40–53.
- Malamed, S.F. (1997). Emergency medicine: beyond the basics (published correction appears in Journal of the American Dental Association, 128, 1070). Journal of the American Dental Association, 128, 843–854.
- Malamed, S.F. (2007). Medical Emergencies in the Dental Office. 6th ed. St. Louis: Mosby.
- Malamed, S.F. (2010a). Sedation: A Guide to Patient Management. 5th ed. St. Louis: Mosby.
- Malamed, S.F. (2010b). Knowing your patients. Journal of the American Dental Association, 141, 3S-7S.
- Mallampati, S.R. et al. (1985). A clinical sign to predict difficult intubation: a prospective study. Canadian Anaesthesia Society Journal, 32, 429–34.
- McFadden, E.R., Jr. and Warren, E.L. (1997). Observations on asthma mortality. Annals of Internal Medicine, 127, 142–7.
- National Heart, Lung, and Blood Institute. (2007). National Asthma Education and Prevention Program Expert Panel report 2: Guidelines for the diagnosis and management of asthma.
- Newacheck, P.W. and Halfon, N. (2000). Prevalence, impact, and trends in childhood disability due to asthma. Archives of Pediatrics and Adolescence Medicine, 154, 287–293.
- Norris, L.H. (1994). Early recognition limits in in-office emergencies. Journal of the Massachusetts Dental Society, 43, 19–23.
- Nuckton, T.J. et al. (2006). Physical examination: Mallampati score as an independent predictor of obstructive sleep apnea. Sleep, 29, 903–8.
- Peskin, R.M. and Siegelman, L.I. (1995). Emergency cardiac care: moral, legal, and ethical considerations. Dental Clinics of North America, 39, 677–688.
- Reed, K.L. (2010). Basic Management of Medical Emergencies: Recognizing a Patient's Distress. Journal of the American Dental Association, 141, 20s– 24s.
- Ross, P.J., Schneider, P.E., Helpin, M. (2013). Neurocardiogenic syncope of child dental patient: a case review. Pediatric Dentistry, 35, 71–73.
- Samsoon, G.L. and Young, J.R. (1987). Difficult tracheal intubation: a retrospective study. Anaesthesia, 42, 487–490.
- Simons, F.E.R. et al. (1998). Epinephrine absorption in children with a history of anaphylaxis. Journal of Allergy and Clinical Immunology, 101, 33–7.
- Simons, F.E.R., Gu, X., Simons, K.J. (2001). Epinephrine absorption in adults: intramuscular versus subcutaneous injection. Journal of Allergy and Clinical Immunology, 108, 871–873.
- Wieling, W., Ganzeboom, K.Z., Saul, J.P. (2004). Reflex syncope in children and adolescents. Heart, 90, 1094–1100.
- Wolters, U. et al. (1996). ASA classification and perioperative variables as predictors of postoperative outcome. British Journal of Anaesthesiology, 77, 217–22.
- Zerella, J.T. et al. (1998). Foreign body aspiration in children: value of radiography and complications of bronchoscopy. Journal of Pediatric Surgery, 33, 1651–1654.
