child dental death

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Eh, I actually know a few dental anesthesiologists who trained at my program and they're all just fine... Though there was only one in my year. Regardless, it's impossible to know what happened in this case and therefore impossible to know if all the training in the world would have made a difference.

I think we can all agree sedated kids without a protected airway with a surgeon working in the mouth in any setting, but esp dental office, is asking for trouble, and occasionally it happens.

Well, not sure that all do agree. This was was I was getting at before, is this common/standard of care for office based dental sedation? Some of my partners do kids at dental offices but they are intubating.

Members don't see this ad.
 
Well, not sure that all do agree. This was was I was getting at before, is this common/standard of care for office based dental sedation? Some of my partners do kids at dental offices but they are intubating.
There is a dentist anesthesiologist who posts here from time to time. States that they do most of their airways open. That's how they are taught. He works in Southern California but don't remember his name. Will look it up.
 
Last edited:
  • Like
Reactions: 1 user
Members don't see this ad :)
There are some dental schools that sit in with medical students during their first two years. So not all dental schools are created equal.

How does that work? Don't they also have to take dental-specific classes during their first two years as well? I know my wife certainly did.
 
You know abou ONE dental school. And using that to make a very broad generalization. And arguing with someone who actually trained with a dentist anesthesiologist. Your n=1 of your wife does not apply to all dental schools and dentists.

Like medical schools, dental schools probably have to meet very strict accreditation standards and as a result probably have little room to vary their curricula from those of other dental schools. Common sense should tell you that one dental school isn't going to provide a radically different exposure to the medical sciences than others.
 
Like medical schools, dental schools probably have to meet very strict accreditation standards and as a result probably have little room to vary their curricula from those of other dental schools. Common sense should tell you that one dental school isn't going to provide a radically different exposure to the medical sciences than others.

yea like crna schools hehehe
 
yea like crna schools hehehe

No. Not like CRNA schools. There are no "dentist mills" like there are CRNA mills. If there's one thing I remember of my wife's experience, it's that dental schools try to produce quality, not quantity, and keep very close tabs on their students.
 
I was under the impression that he's an MD anesthesiologist who staffs dental offices. Smart guy.

Yes, MD doing almost exclusively pediatric dental is my understanding as well - didn't mean to imply he's a "dental anesthesiologist". Hopefully he'll chime in.
 
Members don't see this ad :)
My than 4 year old kid had dental procedure "under sedation". I took him to a full service hospital with immediate ent and anesthesia access.

I ain't taken any chances with my own kid.
 
My than 4 year old kid had dental procedure "under sedation". I took him to a full service hospital with immediate ent and anesthesia access.

I ain't taken any chances with my own kid.

heck I wouldn't even take any chances with someone's else kid. apparently some anesthesiologists do.
 
  • Like
Reactions: 1 user
I understand by why ENT?
I'm always think worst case situation when dealing a kid's airway/mouth.

My friends have had a few close calls at office base dental anesthesia and that's with just adults and general anesthesia.

I think people push the limits how young is too young to sedate kids in dental offices. Or just sedation in general. GI docs one time tried to ask if u can give propofol to pediatric egd as young as age 5. (no anesthesia machine, they don't even officially even carry sux either cause they don't want to pay for dantrolene).

Yes. Risks of sedation are same outpatient or in hospital or office. We all know that.

But sometimes u gotta think about the entire support staff availability.
 
I'm always think worst case situation when dealing a kid's airway/mouth.

My friends have had a few close calls at office base dental anesthesia and that's with just adults and general anesthesia.

I think people push the limits how young is too young to sedate kids in dental offices. Or just sedation in general. GI docs one time tried to ask if u can give propofol to pediatric egd as young as age 5. (no anesthesia machine, they don't even officially even carry sux either cause they don't want to pay for dantrolene).

Yes. Risks of sedation are same outpatient or in hospital or office. We all know that.

But sometimes u gotta think about the entire support staff availability.

Did you do the GI case??

Anyway, not really in kids but in adults, would you guys wait for a ENT to show up (likely several minutes minimum for them to come) to do the emergent trach, or do you guys just crico and ventilate?
 
the ENT surgeons i've seen have no experience working against the rapidly ticking clock of hypoxia, we absorb that pressure regularly.
i've seen them putz around with an awake trache with little appreciation of the impending disaster and urgency...i'd do my own
 
  • Like
Reactions: 1 user
the ENT surgeons i've seen have no experience working against the rapidly ticking clock of hypoxia, we absorb that pressure regularly.
i've seen them putz around with an awake trache with little appreciation of the impending disaster and urgency...i'd do my own

True. Need to see who's available and how long it's been since they don't real ent cases.

We know the situation that happened in the Joan rivers case

Not sure how long it's been since the ENT (who left the room) last even did a real inpatient trach or real inpatient cases

Same goes for the anesthesiologist. Who knows how long it's been since she's done real cases inpatient dealing with real airway issues

While I know many people who only do "outpatient" primary Asa 1-2 cases. But if those outpatient cases primary involve endo, podiatry etc where they don't regularly intubate. That 0.01 percent time u run into trouble can be deadly.
 
I'm always think worst case situation when dealing a kid's airway/mouth.

My friends have had a few close calls at office base dental anesthesia and that's with just adults and general anesthesia.

I think people push the limits how young is too young to sedate kids in dental offices. Or just sedation in general. GI docs one time tried to ask if u can give propofol to pediatric egd as young as age 5. (no anesthesia machine, they don't even officially even carry sux either cause they don't want to pay for dantrolene).

Yes. Risks of sedation are same outpatient or in hospital or office. We all know that.

But sometimes u gotta think about the entire support staff availability.

I'll do propofol EGD for 5 year old if I have my machine and all the stuff. Younger than that usually just intubate (I know many use LMA).
 
The only dental I do is in the OR: nasal intubation, GA. What is typically used in the office setting? Propofol infusion?

Not sure about not having a secure airway with the dentist mucking around in the mouth, but maybe that's common?
Techniques vary. I personally do GA with a nasal ETT. I think it depends on where you trained and where you practice.
 
Top