Daniel Powers,a 32-year-old developmentally delayed male scheduled for dental rehabilitation,became agitated on admission to the preoperative holding unit.In spite of sedation and the calming attention of the nurses and his parents,he was screaming and rapidly turning his head from side to side.He vomited and choked twice before he fell into a light but restless sleep.During the short procedure,the anesthesia provider was aware of rigidity and difficulty with ventilation in Daniel's chest,yet his oxygen saturation was between 96% and 100% throughout the procedure.On extubation,Daniel presented with coughing,wheezing,dyspnea,use of accessory muscles,and tachypnea.Daniel is presenting with probably caused by .

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Daniel has bronchospasm caused by aspiration of vomitus.Aspiration is the passage of regurgitated material into the lungs and can occur during the perioperative period,with most aspirations occurring during tracheal intubation or extubation.Prevention of aspiration postoperatively includes responding quickly to reports of nausea and vomiting,avoiding conversations that could elicit nausea and vomiting,and preventing rapid movement of the head.Bronchospasm is a lower airway obstruction caused by spasms of the bronchial tubes.The patient presents with wheezing,dyspnea,use of accessory muscles,and tachypnea.Bronchospasm can result from aspiration,pharyngeal suctioning,or histamine release secondary to allergic response or related to medication use.

Daniel Powers,a 32-Year-Old Developmentally Delayed Male Scheduled for Dental Rehabilitation,became