Has anyone ever seen this happen??????

[LoriAlabamaRN]

I'm sorry for the long post, but this was a new one for me...

Yesterday, at about 5am I was in my office when I heard an urgent overhead page from the rehab wing. I ran down the hall, and a resident was at the nurses station in a wheelchair, having a grand mal seizure. He was not breathing. His lower dentures were on his shirt, and something told me to get his upepr dentures. I pulled his head up and stuck my hand in his mouth... nothing. I stuck my hand further down his throat, and could barely feel the edge of them, deep in his airway. I was able to force my hand in enough to pinch the edge between two fingers and pull them out of his throat, at which time he took a huge gasping breath and stopped seizing. He was still unresponsive, though, and remained so throughout the incident until he was taken out by the ambulance.

What I want to know, has anyone else ever seen this happen? I swear it had to be God telling me to get his dentures, because I have never seen or heard about someone's dentures doing that. Somehow they had flipped over and gone down front first, so they were shaped like a "U" in his throat, completely occluding the airway. I believe he had a major CVA, because he had decerebrate posturing and his left side was sagging. I'm still shaky at what could have happened if I hadn't thought of his dentures, we would have sent him out with them lodged in his throat.

Has anyone ever seen or heard of this???

[vamedic4, EMT-P]

Good for you Lori!!!! Quick thinking saved this guy's life!!!

I've never seen that happen...but it doesn't surprise me.

KUDOS TO YOU!!!

Good job.

vamedic4;)

[traumaRUs, MSN, APRN]

Nope - never seen it. However, he was lucky you were there! Congrats!

[UM Review RN, ASN, RN]

Wow, Lori! GREAT SAVE!!!

Thanks for sharing this experience. I've never heard of this happening either, but now that I know that it can....

[vampiregirl, BSN, RN]

Great job Lori- quick thinking!

I've seen loose dentures partially obstruct an airway (in the mouth), but never deeper than that. A good reminder of the importance of checking ABC's in any emergency.

[zacarias, ASN, RN]

Wow, you are very smart and quick on your feet. You knew exactly what to do!

[sister--*]

Was talking with an old timer just last week and she was telling about a very similar event that occured to her years ago.

Someone was whisking a non-responsive elderly pt. to the E.R. in a w/c. They found she had swallowed her top denture and had occulded her airway. This was an alzheimers pt.

She recovered to her pre-situation condition.

How odd that the larger dental plate was swallowed instead of the smaller bottom plate.

[LuvMyGamecocks]

Great thinking!!

This happens to be right up my alley....not denture swallowing, but dentures in general. I manage a dental lab, at least until clinicals come along.

We have heard and seen SO many things that you wouldn't believe...and yes, I'm one of those that HAS heard of this (a denture being swallowed). What you described was a denture with a "horseshoe" palate, which is often used when a patient cannot tolerate the full palatal coverage due to a strong gag reflex. Dentists will have labs fabricate that only occasionally, in extreme circumstances, because of the ease with which a horseshoe palatal denture can become loose and occlude an airway.

Not trying to hijack your thread, Lori, but I have a dental/medical story for ya...

The patient had a cast metal partial that we were asked to repair and add a tooth. Apparently, he had been in a car accident and while being treated at the hospital, his doc ordered a MRI. The patient was asked if he had dentures, he said no (thinking that a "denture" meant a FULL denture, and did not include a partial denture). Once the machine started, the partial was ripped out of his mouth, taking a nearby tooth with it. (Details are sketchy, as it was the dentist, not the patient, that told us about it.)

We couldn't repair it, it was sooo warped. The next partial was more expensive, but it was made out of titanium.

[vampiregirl, BSN, RN]

Thanks for the interesting info LuvMyGamecocks!

[myrianekes]

usually happening because seizures.. it comes after with gasping of breath, unvoluntary deep breathing, it can happen all the time to patients who experienced seizures and have their dentures on

[KRVRN, BSN, RN]

GREAT PICK UP! Good job!

[Antikigirl, ASN, RN]

Good for you!!!!!!! Awesome call!!!!!!

I have seen seizures all the time at the ALF I worked in, and most of the pts had dentures! Do remember people do not breathe during seizures, however after seizure I told all the RN's and CNA's that AIRWAY was A #1 within seconds for that first deep breath after seizure...it could suck up anything in or around the mouth! I had a fellow nurse loose her pen light that way once (we got it out before going too deeply).

I was fortunate that typically dentures were shaken out or found their way out...but I can see how they may be jostled back! I haven't seen that yet...whew!

I worry about my former employers facility though...I was a calm person when it came to pt emergencies like seizures and knew what to check right away (typically ABC!!!)...but I don't think, despite my education toward the staff...they really got it...they tend to freak out and just call 9-11! (more so now since they are hiring more unlicensed care givers that don't even have CPR, and they won't pay for staff CPR anymore and don't require it except for RN's, which there is only 1 per shift in a huge facility!!! IE one reason out of many I left).