Podcast
Questions and Answers
What percentage of dentists reported up to 3 medical emergencies in a 12-month period?
What percentage of dentists reported up to 3 medical emergencies in a 12-month period?
How often should dental practitioners update their training in BLS and use of AED?
How often should dental practitioners update their training in BLS and use of AED?
What is the recommended approach to assess an acutely ill patient?
What is the recommended approach to assess an acutely ill patient?
What is the most common medical emergency reported in dental practice?
What is the most common medical emergency reported in dental practice?
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What is the minimum number of people recommended to be available to deal with a medical emergency during treatment?
What is the minimum number of people recommended to be available to deal with a medical emergency during treatment?
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What is the recommended location for an Automated External Defibrillator (AED) in a dental practice?
What is the recommended location for an Automated External Defibrillator (AED) in a dental practice?
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What is the primary purpose of using risk assessment tools such as ASA classification in dental practice?
What is the primary purpose of using risk assessment tools such as ASA classification in dental practice?
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What is the recommended timeframe for staff to update their CPR skills?
What is the recommended timeframe for staff to update their CPR skills?
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Why is it recommended to use FFP3 masks or respirators when performing chest compressions on patients with suspected or confirmed COVID-19?
Why is it recommended to use FFP3 masks or respirators when performing chest compressions on patients with suspected or confirmed COVID-19?
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What is the primary goal of resuscitation training in dental practice?
What is the primary goal of resuscitation training in dental practice?
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What is the recommended action to take when a patient is suspected or confirmed to have COVID-19 and requires chest compressions?
What is the recommended action to take when a patient is suspected or confirmed to have COVID-19 and requires chest compressions?
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Why is it essential to include resuscitation training as part of the induction for new staff members?
Why is it essential to include resuscitation training as part of the induction for new staff members?
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What is the primary indicator of a patient's airway, breathing, and perfusion to the brain being okay?
What is the primary indicator of a patient's airway, breathing, and perfusion to the brain being okay?
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What should be done immediately if a patient is not breathing?
What should be done immediately if a patient is not breathing?
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What is the primary cause of fainting according to the FAINT symptoms and signs?
What is the primary cause of fainting according to the FAINT symptoms and signs?
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What is the recommended oxygen flow rate for managing fainting?
What is the recommended oxygen flow rate for managing fainting?
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What is the primary cause of hyperventilation according to the symptoms and signs?
What is the primary cause of hyperventilation according to the symptoms and signs?
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What is the recommended method for returning CO2 levels to normal in hyperventilation management?
What is the recommended method for returning CO2 levels to normal in hyperventilation management?
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What is the primary cause of postural hypotension according to the symptoms and signs?
What is the primary cause of postural hypotension according to the symptoms and signs?
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What is the primary risk of choking and aspiration in dental patients?
What is the primary risk of choking and aspiration in dental patients?
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What is the recommended management for a patient who is coughing and spluttering due to choking and aspiration?
What is the recommended management for a patient who is coughing and spluttering due to choking and aspiration?
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What should be done if the patient becomes unconscious due to choking and aspiration?
What should be done if the patient becomes unconscious due to choking and aspiration?
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Study Notes
Management of Medical Emergencies
- Medical emergencies can happen at any time in general dental practice, and at least two people should be available to deal with them when treatment is planned.
- Dental practitioners are expected to be competent in managing common medical emergencies, and all members of staff should know their role in medical emergencies, practise regularly together in a simulated medical emergency.
Expectations
- A process to assess patients at risk should be in place at all dental practices.
- The 'ABCDE' approach should be used to assess acutely ill patients.
- Specific emergency drugs and equipment should be available immediately.
- All clinical areas should have immediate access to an Automated External Defibrillator (AED).
- Training in BLS and use of AED should be updated annually.
Incidence
- The commonest medical emergencies in dental practice are vasovagal syncope (63%), angina (12%), hypoglycaemia (10%), seizures (10%), choking (5%), and anaphylaxis.
- Medical emergencies occur more frequently, with 57% of dentists reporting up to 3 emergencies and 36% of dentists reporting up to 10 emergencies in a 12-month period.
Risk Assessment
- Medical and drug history should be taken by the dental practitioner to identify patients at risk.
- Modification of the planned treatment or referral to the hospital may be appropriate.
Training
- Training in CPR should include recognition of cardiac and respiratory arrest, summoning help, starting CPR, and using AED within 3 minutes.
- Staff should update their skills at least annually.
- Resuscitation training is fundamental and should be a part of the induction for new members of staff.
COVID Update
- Follow 2021 guidelines for resuscitation for those working in healthcare settings.
- Use of FFP3 masks or respirators as well as eye protection is recommended when performing chest compressions for patients with suspected or confirmed COVID-19.
ABCE Approach
- A - Airway: Look, listen, and feel for airway noises, head position, foreign body, fluid, oedema, and respiratory rate and effort.
- B - Breathing: Check for breathing, subcutaneous emphysema, and symmetry of chest movement.
- C - Circulation: Check heart rate, blood pressure, capillary refill time, bleeding, and skin colour.
- D - Disability: Check AVPU, GCS, pupils, diseases, blood glucose, and neuro exam.
- E - Exposure: Perform a general examination, revealing other symptoms, and thermomanagement.
FAINT
- Symptoms and signs: dizziness, slow pulse rate, low BP, pallor, sweating, nausea, vomiting, and loss of consciousness.
- Management: Lay patient flat, raise legs, loosen tight clothing, give 15L oxygen, and check for 'signs of life' and start CPR if unresponsive.
Hyperventilation
- Symptoms and signs: lightheadedness, generalised paraesthesia, fast breathing, and panic.
- Management: Reduce anxiety and reassure, return CO2 level in blood to normal by rebreathing from cupped hands or reservoir bag.
Postural Hypotension
- Symptoms and signs: lightheadedness, dizziness, loss of consciousness on upright standing position from supine.
- Management: Lay flat, give oxygen 15L/min, and sit up very slowly, particularly if patient is on ß-blockers.
Choking and Aspiration
- Symptoms and signs: coughing, spluttering, difficulty breathing, noisy breathing, wheeze or stridor, and cyanosis.
- Management: Encourage patient to cough vigorously, deliver sharp back blows, and follow with abdominal thrusts if foreign body has not been dislodged. Start CPR if patient becomes unconscious.
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Description
Test your knowledge on managing medical emergencies in dental practice, including adult basic life support, advanced life support, and emergency equipment. Learn about first-line treatment protocols and when to transfer to A&E. This quiz covers key points from Dr. Evgeny Kushnerev's lecture on medical emergencies.
