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Asthma Emergency Management — MFDS Part 1 MCQ

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EasyHuman DiseaseAsthma Emergency ManagementMFDS Part 1

During dental treatment, a conscious adult with known asthma develops wheeze and breathlessness but can still speak in full sentences. There is no urticaria, facial swelling or hypotension. What is the most appropriate immediate management?

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Correct answer: B — Sit the patient upright and give inhaled salbutamol using a spacer

The correct answer is B. Stop dental treatment, sit the patient upright and administer inhaled salbutamol, preferably through a spacer. Dental emergency guidance recommends an initial two puffs of salbutamol 100 micrograms per puff, with repeated doses if required. If the attack is severe, life-threatening or does not respond, call 999; while awaiting the ambulance, administer oxygen and further salbutamol via the spacer, one puff at a time up to 10 puffs according to response. Laying the patient flat may worsen breathing. Intramuscular adrenaline is indicated for anaphylaxis, for which the stated skin, mucosal and circulatory features are absent. Glyceryl trinitrate treats angina, while intravenous hydrocortisone is not the immediate first-line bronchodilator treatment.

Reference: Scottish Dental Clinical Effectiveness Programme Practice Support Manual, Medical Emergencies in the Dental Practice: Asthma, May 2020. https://www.psm.sdcep.org.uk/media/3hlkptix/medical_emergencies_in_the_dental_practice.pdf