This was originally supposed to be a funny post. We've had several people come in with dental abscesses, and I always joke with the OR nurses and ask them "What have you learned today?" To which the answer is "Always brush your teeth!"
The 1st time I ever performed CPR on a live person (not the dummies we practice on) was a guy who came in for a dental abscess and stopped breathing on the table. Luckily, it was only for a few seconds and we got him back.
Then we had a lady who had a track of pus going all the way up her cheek and to her skull above her ear. We opened it up and pus just kept coming. Her aponeurosis was necrosed and we had to dissect it out. This is a dental abscess, and here I am, looking at her cranium!! She's an elderly lady, and I was actually afraid she wasn't going to be able to kick the infection. Amazingly, she's doing well.
However, yesterday we had another dental abscess. Young, otherwise healthy female. Huge amount of pus. She aspirated. She desatted, and try as we may, she just kept going south. We were trying to suction the pus out of her lungs, and giving her O2, but nothing seemed to help. After about 15 minutes of having O2 sat between 60-70% and a heart rate above 150bpm, she arrested. I jumped on the table and started doing compressions. I looked at her eyes and her pupils were fixed and dilated. I knew her brain had been without oxygen for too long. She died.
(Here is Dr. Scott's blog about what happened, in case you want more details: https://gardners2koza.wordpress.com/2016/02/25/death-in-the-or/ )
So what was going to be a funny post about the importance of good dental hygiene, became a tragic post about the 1st patient who I've seen die on the table. Because of a stupid dental abscess. It seemed totally surreal. I'll never forget the look on her mother's face.
So if you're reading this, thank your lucky stars that you have access to a dentist, a toothbrush, and toothpaste. Make sure you use it. It may quite literally save your life.
(The pictures below are from the 2nd case described, the elderly lady with pus tracks going up to her skull.)
The 1st time I ever performed CPR on a live person (not the dummies we practice on) was a guy who came in for a dental abscess and stopped breathing on the table. Luckily, it was only for a few seconds and we got him back.
Then we had a lady who had a track of pus going all the way up her cheek and to her skull above her ear. We opened it up and pus just kept coming. Her aponeurosis was necrosed and we had to dissect it out. This is a dental abscess, and here I am, looking at her cranium!! She's an elderly lady, and I was actually afraid she wasn't going to be able to kick the infection. Amazingly, she's doing well.
However, yesterday we had another dental abscess. Young, otherwise healthy female. Huge amount of pus. She aspirated. She desatted, and try as we may, she just kept going south. We were trying to suction the pus out of her lungs, and giving her O2, but nothing seemed to help. After about 15 minutes of having O2 sat between 60-70% and a heart rate above 150bpm, she arrested. I jumped on the table and started doing compressions. I looked at her eyes and her pupils were fixed and dilated. I knew her brain had been without oxygen for too long. She died.
(Here is Dr. Scott's blog about what happened, in case you want more details: https://gardners2koza.wordpress.com/2016/02/25/death-in-the-or/ )
So what was going to be a funny post about the importance of good dental hygiene, became a tragic post about the 1st patient who I've seen die on the table. Because of a stupid dental abscess. It seemed totally surreal. I'll never forget the look on her mother's face.
So if you're reading this, thank your lucky stars that you have access to a dentist, a toothbrush, and toothpaste. Make sure you use it. It may quite literally save your life.
(The pictures below are from the 2nd case described, the elderly lady with pus tracks going up to her skull.)
During the procedure
During dressing change
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