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Respiratory system |
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¨ Respiratory disorders may present with cough, sputum, wheeze or haemoptysis. ¨ Differentiation from cardiac disease (which may be concurrent) can be difficult since certain features are common to both. These include dyspnoea, finger clubbing and cyanosis. A thorough history helps in differentiation. ¨ Respiratory failure can be precipitated in a patient with respiratory impairment if they have a GA. ¨ The impairment may be temporary e.g. because of infection. An upper respiratory tract infection may progress to the chest and therefore a GA should be postponed in the non-urgent case. ¨ Enquiry should be made regarding the efficacy of medication e.g. inhalers used in the management of asthma and should be available for use if required. The possibility that the patient may be taking (or have taken) steroids should be borne in mind. ¨ Patients who are short of breath feel more comfortable in a sitting position rather than supine.
Respiratory disorders are common and their main significance in dentistry relates to intravenous sedation, general anaesthesia and the unwanted effects of prescribed drugs. The degree of compliance achievable for local analgesia may also be compromised. As with most disorders the history is important in the assessment of such patients.
The respiratory system is always affected to some extent by smoking and enquiry should always be made with regard to smoking habits.
Cough¨ Cough is a non-specific reaction to irritation anywhere from the pharynx to the lungs. ¨ It may produce sputum or be non-productive. ¨ Haemoptysis (coughing up of blood) may occur and it is important to differentiate this from haematemesis (vomiting of blood). ¨ Large volumes of blood may be coughed up in lung cancer, bronchiectasis and tuberculosis. ¨ Lesser amounts may be observed in pneumonia and pulmonary embolism.
Ref: British Dental Journal 14 June 2003; Volume 194, No. 11
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