Airway Obstruction

I think of all the emergencies, this is the one we as dentists are intuitively best at preventing, and prevention is the key. Dentistry is all about using small objects, in a slippery environment, all poised to go right down someones windpipe.  Prevention is highly emphasized here because once an airway becomes obstructed, we have a very short time to deal with this life threatening emergency.

We work all the time with techniques and vigilence to prevent this.  Use a gauze as a drape to prevent objects from going down the patients throat.  Use a rubber dam whenever possible.  Tie floss to small instruments like implant screw drivers, so they can be easily retrieved.  Also, tell your patient when you are using something small that is hard to hold onto and may not be easy to prevent going down.  Prepare them ahead of time, so if the object does slip, they are prepared to lean forward and spit it out for you.  

When an airway is totally obstructed it is obvious.  The patient will grasp at their throat, panic and sometimes try to flee the scene.  Treatment is to perform the Heimlich manuever immediately to clear the object.  If the airway is only partially blocked, ask if the victim needs help.  If they can respond no encourage them to cough to clear the object.  If they can not respond, ask them if they need help.  If they signal they do, treat the victim the same as if the airway were completely blocked by perfomring the Heimlich manuever.  

The Heimlich maneuver can be performed from standing for a conscious person, or on a lying down for an unconscious person.  You can even perform it on yourself over the back of a chair if you choke while you are alone. 

The Mayo Clinic has a nice website giving more info and instructions in technique.  Click here to view it.

Also, Youtube has many instructional videos in the Heimlich maneuver.

© Erik M. Richmond, DMD