By H. Keith Couch, DMD No one wakes up and says, “Today’s the day I’m going to enjoy a full-fledged emergency.” Most of us are caught completely unaware and can only hope we’re fortunate enough to receive the attention of a trained professional. Like many others, I was initially hesitant to take courses addressing emergency procedures. But as the following examples will show, I am very glad I did. Unblocking an airway Three years ago my receptionist bolted into the operatory. She told me a man was lying unconscious in the parking lot. After instructing her to dial 911 I grabbed the AED and a mobile oxygen tank. Accompanied by an assistant, I dashed outside. My partner was already tending the patient, checking his airway and pulse. A dislodged denture appeared to be obstructing the man’s airway. Once we removed the denture he regained a healthier pallor and began breathing normally. Because the man was still unconscious, we hooked him up to the oxygen and tilted his head back to improve the airway. Minutes later he regained consciousness and EMTs arrived. He was taken to the hospital and held overnight. No significant problem was found. Best efforts don’t always succeed The mouth of the Columbia River contains some of the nation’s best salmon fishing. While enjoying the pursuit of silvers a few years ago, I heard a companion say, “I’ve got a big one on.” I checked my own pole to make sure I wasn’t in his way. But suddenly I watched his own equipment fly from the boat, while he fell unconscious to the deck. I quickly called for a first-aid kit or AED. But the captain said he had neither of those things. I advised him to alert the Coast Guard while I rapidly moved the man’s head to the side. As I checked his airway a large piece of candy fell from his mouth. It seemed highly probable this was the source of the problem. As I had been taught, I also tipped the man’s head back and thrust his jaw forward in an attempt to improve his airway. His pallor improved as I did so. By this time another individual was monitoring the man’s pulse. The man was still unconscious, although his pulse appeared to be stable. Thirty minutes later the Coast Guard arrived and transported the man to a waiting ambulance. I later learned that he died on the way to a hospital. I was deeply saddened by the man’s death. Our best efforts did not alter the outcome. But when the man’s daughter called me several weeks later to express her appreciation, it was gratifying to reassure her that onlookers had not stood idly by while her loved one suffered.

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The information contained in this, or any case study post in Incisor, should never be considered a proper replacement for necessary training and/or education regarding adult oral conscious sedation. Regulations regarding sedation vary by state. This is an educational and informational piece. DOCS Education accepts no liability whatsoever for any damages resulting from any direct or indirect recipient's use of or failure to use any of the information contained herein. DOCS Education would be happy to answer any questions or concerns mailed to us at 3250 Airport Way S, Suite 701 | Seattle, WA 98134. Please print a copy of this posting and include it with your question or request.
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