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Swallowing Foreign Objects Policy

Protocol for incidents involving patients swallowing various foreign objects associated with dental treatment provision – rubber dam clamps, burs, crowns, implant parts and pieces of broken instruments:

  1. The provider will stay with the patient, monitor vital signs, observe for acute respiratory distress, and make a preliminary diagnosis from the clinical signs and symptoms and the patient’s response to careful questioning


  2. The provider will send a staff assistant or other provider to inform the clinic clerks to notify Radiology at 537-3561 (when there is no emergency condition such as respiratory distress).   Inquiry needs to be made by the provider as to whether the patient has a UNC Hospitals Medical Record (MR) number and make note of it.  If not, or if the patient is unsure or unaware of their MR number, attending faculty or student will make a call from the School of Dentistry to UNC Hospitals’ registration office at 966-2555.  Explain the necessity to expedite the call quickly.   Registration information from the patient’s chart will be required to register the patient.   Make a note of the MR number to be given to the School of Dentistry Radiology Department.  Instruct the patient that if they receive a bill from the hospital, they should forward it to the Office of Clinical Affairs.

  3. The attending DDS will explain to the patient the procedure for getting radiographs.  The patient will then be taken to Radiology (1st floor Tarrson Hall) for the necessary arrangements/paperwork from the radiology staff.  Notify the radiology staff of the patient’s MR number.

  4. Transportation to Hospital Radiology (x-ray) is the responsibility of the provider or attending DDS.  Transportation for sedated (but not emergent) patients may pose special risks.   Obtain a wheelchair from the ground floor Tarrson Hall, Dental Faculty Practice, Graduate Periodontics or Oral Surgery and transport the patient to the hospital.   NOTE:  AN ADDITIONAL PERSON MUST ACCOMPANY THE PROVIDER WHEN TRANSPORTING THE PATIENT TO HOSPITAL RADIOLOGY.

  5. One escort will stay with the patient in Radiology while the other escort registers the patient on the mezzanine level of the Mail Hospital, next to the Phlebotomy Lab.

  6. When the radiology technician calls the patient back to take the film, ask to see the radiograph when it is ready in order to determine the location of the foreign object.

  7. If there is any question as to whether the patient has passed the object within three days, it is the responsibility of the provider to arrange for a follow-up radiograph to be taken.

  8. Complete an Incident Report and forward it within 48 hours to the Office of Clinical Affairs (452 Brauer Hall).

  9. Make an entry in the patient’s record completely describing the occurrence, but do NOT refer to the Incident Report in your entry.

  10. If the patient refuses the radiograph, proper notation should be documented in the chart.

Last Modified: 11/12/2012