Medical Emergencies · single question
A patient with COPD comes in for dental treatment. Which of the following statements is TRUE regarding dental management?
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Correct answer: D. The patient cannot be placed in a fully supine position, and epinephrine use should be limited
COPD patients have two key considerations: (1) They cannot tolerate a fully supine/reclined position because it worsens dyspnea — they should be kept semi-reclined or upright. (2) Epinephrine is NOT absolutely contraindicated but should be used judiciously in limited amounts — high-dose epinephrine can worsen cardiac strain and bronchospasm in COPD. The critical distinction: LIMIT epinephrine, do not eliminate it.
- A. Epinephrine is NOT absolutely contraindicated in COPD. It should be used in limited amounts with caution, but avoiding it entirely is overly restrictive.
- B. Upright position is correct, but saying epinephrine must be 'completely avoided' is incorrect — it should be limited (used judiciously), not completely avoided.
- C. Modifications ARE needed for COPD patients — both positioning and epinephrine considerations must be addressed.
- D. CORRECT. COPD patients cannot be placed in fully supine position (worsens breathing) and epinephrine should be LIMITED — used carefully in reduced doses, not completely eliminated.
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