Aspiration

Dental patients are susceptible to aspiration due to the presence of blood and secretions in their mouths for prolonged periods, suppressed pharyngeal reflexes due to local anaesthesia or the presence of impression material or dental equipment in their mouths.

Signs and symptoms include:

  • Patient may cough and splutter
  • Patient may complain of breathing difficulty
  • Breathing may become noisy (stridor)
  • Patient may develop ‘paradoxical’ chest or abdominal movements
  • Patient may become cyanosed and lose consciousness

Management

  • Encourage patient to cough vigorously.

Administer 100% oxygen

Flow rate: 15 litres/minute.

As for adults

For adults:

Administer 100% oxygen

Flow rate: 15 litres/minute.

For children:

As for adults


Administer a salbutamol inhaler, 4 puffs (100 micrograms per actuation), through a large-volume spacer, repeat as needed.                                      

Salbutamol inhaler

2–17 years

1 puff via a spacer every 15 seconds (max. 10 puffs), repeat above regime at 10 – 20 minute intervals as needed.

For adults:

Administer a salbutamol inhaler, 4 puffs (100 micrograms per actuation), through a large-volume spacer, repeat as needed.                                      

For children:

Salbutamol inhaler

2–17 years

1 puff via a spacer every 15 seconds (max. 10 puffs), repeat above regime at 10 – 20 minute intervals as needed.

  • If you suspect that a large fragment has been inhaled or swallowed but there are no signs or symptoms, the patient should be referred to hospital for x-ray and removal of the fragment if necessary.
  • Where the patient is symptomatic following aspiration, they should be referred to hospital as an emergency.