Tragic death during dental procedure

[propadope]

NC Dental Board approves anesthesia changes, stops short of requiring separate anesthesia provider

Despite a loud push for the dental board to require a separate anesthesiologist or certified registered nurse anesthetist (CRNA) be present when a patient is sedated for dental procedures, the board declined to adopt that change. They have proposed several other changes aimed at improving...

www.wect.com

No surprise there🤷‍♂️ But they are just starting to implement capnography??? Just goes to show how far behind they are

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[Arch Guillotti]

The dental board would also like to see more training offered to dental assistants specifically focused on airway management and patient management

 

[We'llBeDoneIn15Minutes]

I’m still failing to understand why this guy needed anything more than local for an implant.

Exactly. I tell them gas me up on the nitrous and I'm good to go. That stuff works haha and you're awake. No way I'm taking IV meds in a dental office without anesthesia care.

 

[jon stewart]

who ends up approved their certification ? the aba or oromaxillofacial board?

 

[IMGASMD]

who ends up approved their certification ? the aba or oromaxillofacial board?

You must be late for the party….. they have nothing to do with the aba. Nor do they believe the aba should have anything to do with them…..

They’re better at sedation and doing procedures than you alone giving anesthesia. (Paraphrasing here.)

 

[coffeebythelake]

Waiting for the next preventable dental anesthesia death in NC.

 

[teacher2md]

Everyone should read this

“Basically, the statistics indicated that either a death or a severe brain injury occurred at least once every six weeks during dental procedures conducted with sedation and anaesthesia”

This is from the former president of the American Society of Dentist Anesthesiologists.

Other notable quotes: “ There definitely seems to be a culture to protect the release of such data.”

Before the dentists jump in here to gaslight us: no, there are not frequent clean kills due to lost airways in healthy patients by anesthesiologists/CRNAs. Those stories make the news.

 

[forchinet121]

Everyone should read this

“Basically, the statistics indicated that either a death or a severe brain injury occurred at least once every six weeks during dental procedures conducted with sedation and anaesthesia”

This is from the former president of the American Society of Dentist Anesthesiologists.

Other notable quotes: “ There definitely seems to be a culture to protect the release of such data.”

Before the dentists jump in here to gaslight us: no, there are not frequent clean kills due to lost airways in healthy patients by anesthesiologists/CRNAs. Those stories make the news.

Wtf..

 

[Anesthesia_Guy]

Wtf..

I'm shocked that it isn't more frequent.

 

[Southpaw]

The dentists show up talkin’ ‘bout their sweet sedation skills in 1….. 2…..

 

[coffeebythelake]

The dentists show up talkin’ ‘bout their sweet sedation skills in 1….. 2…..

They know how to sedate patients better than anyone because they deal with laryngospasm all the time. 🤡

I'm shocked that it isn't more frequent.

dentists claim it is 1 in a million chance of dying from dental sedation. Clearly a lie.

 

[chessknt]

I've seen some cosmetic sites that have some kind of nitrous system that the patient self administers with a mouthpiece with no monitoring. It seems insane to me that a specialist with 0 airway/resuscitation skills (dermatology) can administer unmonitored sedation to patients at outrageous cash rates. No SpO2 monitoring of any kind.

 

[teacher2md]

Another one to add to the list:

Ex-dentist gets probation for procedure that left 4-year-old girl with brain damage

A dentist was sentenced to probation after her botched procedure left a 4-year-old girl permanently brain damaged, blind, mute and in a wheelchair with 24-7 care because she can't walk or eat.

lawandcrime.com

 

[Airway]

I've seen some cosmetic sites that have some kind of nitrous system that the patient self administers with a mouthpiece with no monitoring. It seems insane to me that a specialist with 0 airway/resuscitation skills (dermatology) can administer unmonitored sedation to patients at outrageous cash rates. No SpO2 monitoring of any kind.

I can't find it right now but I believe the Nitronox (TM) (50/50 nitrous/oxygen) doesn't require spo2

Dentists certainly believe it's not necessary Use of pulse oximetry during nitrous oxide- oxygen inhalation sedation: mandatory or recommended? - PubMed

 

[nimbus]

Another one to add to the list:

Ex-dentist gets probation for procedure that left 4-year-old girl with brain damage

A dentist was sentenced to probation after her botched procedure left a 4-year-old girl permanently brain damaged, blind, mute and in a wheelchair with 24-7 care because she can't walk or eat.

lawandcrime.com

It’s absurd how often this happens. Patient has a medical emergency at an outlying facility. Proceduralist fails to call 911 immediately and a malpractice case becomes a criminal case.

 

[Dr. Rude]

I can't find it right now but I believe the Nitronox (TM) (50/50 nitrous/oxygen) doesn't require spo2

Dentists certainly believe it's not necessary Use of pulse oximetry during nitrous oxide- oxygen inhalation sedation: mandatory or recommended? - PubMed

I never used nitrous for labor analgesia. It was also 50% N20/02. was pulse oximetry recommended?

 

[chessknt]

I never used nitrous for labor analgesia. It was also 50% N20/02. was pulse oximetry recommended?

It's apparently only recommended if you have the capacity to actually know how to intervene and fix it. If you are a dermatologist or a dentist with 0 resuscitation skills aside from the stupid computer BLS class you did while watching the real housewives of Miami from your $18M beach house then don't bother I guess?

 

[IMGASMD]

It's apparently only recommended if you have the capacity to actually know how to intervene and fix it. If you are a dermatologist or a dentist with 0 resuscitation skills aside from the stupid computer BLS class you did while watching the real housewives of Miami from your $18M beach house then don't bother I guess?

Why check if you cannot do anything about it…. It’s the same treatment, watchful waiting. Or call the pastor and/or pharmacist.

 

[dozitgetchahi]

Exactly. I tell them gas me up on the nitrous and I'm good to go. That stuff works haha and you're awake. No way I'm taking IV meds in a dental office without anesthesia care.

I had one of my remaining wisdom teeth removed recently. Oral surgeon pushed fairly hard for sedation…finally I was basically like “there’s no way in hell you’re pushing propofol in my veins in this office, with no equipment around that I can see and no anesthesiologist or anyone else present”.

We proceeded with local only, and it was absolutely fine. I’ve never been under any sort of sedation or other anesthesia aside from lidocaine for dental procedures (in fact, I’ve had cavities filled with nothing whatsoever).

 

[Beeftenderloin]

I had one of my remaining wisdom teeth removed recently. Oral surgeon pushed fairly hard for sedation…finally I was basically like “there’s no way in hell you’re pushing propofol in my veins in this office, with no equipment around that I can see and no anesthesiologist or anyone else present”.

We proceeded with local only, and it was absolutely fine. I’ve never been under any sort of sedation or other anesthesia aside from lidocaine for dental procedures (in fact, I’ve had cavities filled with nothing whatsoever).

Same thing happened to my wife for her 1 remaining wisdom tooth. She adamantly refused IV sedation. They looked at her like she had 3 heads. They begrudgingly did it under local only and it was totally fine.

 

[Dr. Rude]

I had nitrous for my wisdom teeth as a teenager. Loved it. Got a great rush.

 

[zizzer]

I had all four of mine removed under sedation a couple of years ago because they said it was their policy to do that when removing all four, although not with just two. Anyway, my dentist is very good at dentistry and seemed to take pretty extensive measures to keep things safe. I let her know I wasn't anxious and didn't really care how light of sedation I received, including none, as long as the local anesthesia was working fine.

Turns out I got a cumulative 10mg of midazolam throughout the procedure. The only parts I remember were certain parts where I was aware and comfortable and thinking, "If I just keep my eyes closed and don't move or make any noise, they won't feel like they need to give me more medicine." I guess I was wrong lol. Also, it took her two tries to get a 22G IV in my giant hand vein. I guess I shouldn't criticize though. I was comfortable and it went well. It just seemed unnecessary.

 

[Crabbygas]

Oh the awesome craziness that is dentistry. When I was a resident I remember hearing some old timer tell me that it was once routine for dentists to use 100% nitrous for removing wisdom teeth. The saying apparently was, "Turn them blue and take out two." In contrast when I had my wisdom teeth taken out in the late 70's I was admitted to the hospital the night before. ADMITTED. and given general anesthesia the next day. Have to admit, it was a sweet way to get it done.

 

[chessknt]

I recall being a teenager and having rigors in the car while falling asleep on the window after having mine done, no recollection at all of going home despite a 30 minute drive. They didn't have a pacu so I guess moms car was the pacu. Super safe because no bad outcome I guess....

 

[DocVapor]

Oh the awesome craziness that is dentistry. When I was a resident I remember hearing some old timer tell me that it was once routine for dentists to use 100% nitrous for removing wisdom teeth. The saying apparently was, "Turn them blue and take out two." In contrast when I had my wisdom teeth taken out in the late 70's I was admitted to the hospital the night before. ADMITTED. and given general anesthesia the next day. Have to admit, it was a sweet way to get it done.

I ask this lovingly, but, like... just how old are you?

 

[Crabbygas]

I ask this lovingly, but, like... just how old are you?

Haha. 59. That's my story and I'm sticking to it!

 

[Dr. Rude]

Oh the awesome craziness that is dentistry. When I was a resident I remember hearing some old timer tell me that it was once routine for dentists to use 100% nitrous for removing wisdom teeth. The saying apparently was, "Turn them blue and take out two." In contrast when I had my wisdom teeth taken out in the late 70's I was admitted to the hospital the night before. ADMITTED. and given general anesthesia the next day. Have to admit, it was a sweet way to get it done.

Elmer McKesson (1881-1935) anesthesiologist was an advocate of 100% N2O until the patient turned blue. He was a pioneer in anesthesia machines and he is solely responsible for the O2 flush valve.

 

[nimbus]

Elmer McKesson (1881-1935) anesthesiologist was an advocate of 100% N2O until the patient turned blue. He was a pioneer in anesthesia machines and he is solely responsible for the O2 flush valve.

Flush valve totally makes sense after you turn the patient blue with nitrous.