Pulmonary Edema

[Audio] Dental Office emergency - Pulmonary Edema.

[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..

[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..

[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,.

[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..

[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.

[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..

[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.

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