Medical Emergencies in Dental Practice

• This lecture aims to prepare individuals to manage the most common medical emergencies in a dental setting.
• Prior to the live activity session, students should examine the medical emergency drug kits at Huntley Street on each level, noting when the trolleys are reviewed. The packages and drawers should be looked at closely.
• The medical emergency kit in Mortimer Market should be located, with the understanding that it may be used on colleagues rather than patients.
• The Life Saver App can be downloaded to a phone for information on common medical emergencies, including assorted medical emergency videos.
• The Basic Life Support training notes provided during the introduction program should be reviewed.

Learning Outcomes

• Dental professionals must understand their role and legal obligations in recognizing and responding to medical emergencies.
• Recognition of common signs and symptoms of medical emergencies in the dental environment is essential.
• Familiarity with the immediate management and appropriate medications for these emergencies is required.
• The medical emergency assessment tool of Airway Breathing Circulation Disability Exposure (ABCDE) should be outlined.
• Proper use of the SBAR (Situation, Background, Assessment, Recommendation) communication tool when contacting emergency services is imperative.
• The General Dental Council (GDC) states that all registrants must be trained in dealing with medical emergencies, including resuscitation, to ensure patient safety on any premises.
• The Care Quality Commission (CQC) provides guidance for dentists, emphasizing the importance of drugs and equipment for medical emergencies.
  • More information can be found on their website: https://www.cqc.org.uk/guidance-providers/dentists/dental-mythbuster-4-drugs-equipment-medical-emergency
• Research suggests a dental professional will likely experience a medical emergency on average once every two years, which can occur anytime.
• Patients may forget to eat, experience stress, or forget to take routine medications, contributing to medical emergencies.
• In some situations, life-saving action may be required before specialist help arrives.
• It should never be assumed a clear medical history rules out the possibility of a medical emergency.
• The most common medical emergencies in a dental setting include:
  • Fainting/Syncope
  • Epilepsy
  • Hypoglycemia
  • Asthma attack
  • Cardiac Emergencies (Angina/Myocardial infarction/Cardiac Arrest)
  • Anaphylaxis
  • Airway obstruction/choking
  • Adrenal crisis
• All medical emergencies follow the same approach with underlying principles:
  • Use the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach for assessment and treatment.
  • Perform an initial assessment and reassess regularly.
  • Treat life-threatening problems first.
  • Assess the effects of treatment.
  • Recognize when extra help is needed and call for it early.
  • Communicate effectively using SBAR.
  • The aim of initial treatment is to keep the patient alive and achieve clinical improvement.
  • Allow emergency medication time to work before considering further or different treatments.
• Every medical emergency should involve an ABCDE assessment:
  • Airway: Ensure it is not obstructed; position the patient accordingly. (Symptoms: Gurgling, Snoring, Stridor, Wheeze).
  • Breathing: Assess breathing pattern, rate, and sounds. (Posture & accessory muscles, Colour of patient, Respiratory rate, Listen to breathing rate and depth).
  • Circulation: Assess the patient's color, pulse, and capillary refill time. (Count the pulse, Assess colour and temperature of fingers, check for chest pain)
  • Disability: Assess pupils' reaction to light and generate reaction to pain. (Level of consciousness, Pupillary Response, Glucose levels, Medical History)
  • Exposure: Examine the patient fully, respecting their dignity and minimizing heat loss. (Safety, Body temperature, Consider Drug use?, Check for Wounds)