dr. suzan hassan. many studies have shown that medical emergencies do occur in the dental practice...

CLINICAL SETUP OF EMERGENCY

Dr. Suzan Hassan

Many studies have shown that medical

emergencies do occur in the dental

practice so that we need to have

appropriate skill and equipment

available to deal with these conditions.

Introduction

Fainting (syncope).

Diabetic coma.

Anaphylactic shock.

Epileptic seizures.

Cardiovascular

collapse.

Adrenal disorders.

Thyroid disorders.

Asthmatic attack.

Stroke.

Common emergency cases

Sudden loss of

consciousness.Chest pain and dyspnea.Convulsions( fits).

Clinical presentation of ER

A\ Prevention includes:

Medical history questionnaire. Documentation of vital signs. Documentation of findings on medical alert Tags(patient

medical file ). Completion of physical assessment of the Pt begins

with the first interaction with patient.

Preparation for Emergency

Start with first interaction with Pt.

Note abnormalities of Pt voice on telephone

during appointment scheduling.

Assess over all appearance when Pt enters the

clinic.

Document findings in patient chart.

Physical assessment (signs & symptoms).

Comprehensive medical history.

Patient Assessment

Medication has taken within 2 years.

Allergies and adverse drug reactions.

Medical emergencies had previously.

Vital signs (pulse, respiratory rate, blood

pressure, temperature, weight).

Extra oral & Intraoral examination.

Comprehensive documentation of findings.

Consider using pre medication or sedation.

Schedule morning appointment.

Eat breakfast or lunch before appointment.

Minimize waiting time.

Make sure to use adequate pain control.

Stress minization to prevent risk of emergency

All staff in dental practice should have

appropriate training of basic life support.

Basic Emergency procedures:

Monitor BP & Pulse.

Clear and maintain airway.

Cardiopulmonary resuscitation

Intravenous cannulation.

B\Training:

PART II

Basic Life Support

Air way breathing circulation

A : open air way. Use head tilt-chin lift. Suction as necessary. B :check for breathing If not, give 2 breath via mask (100%). Call for Automated Electronic

Defibrillator(AED). C : check for pulse If no lay Pt flat and being chest compressions. Apply AED. If present check the rate.

A B C

Telephone

Oxygen cylinder & mask

Disposable airway

Disposable syringe& needles.

Emergency Equipment

IV cannulae Nebulizer of adrenaline

Portable suction Automated Electronic Defibrillator(AED)

Magill intubation forceps

Alcohol swap& tape

Adrenaline 1:1000 (0,5ml ampoules)

Glyceryl trinitrate 500mg

Aspirin 300mg

hydrocortisone 100mg

chlorpheniramine 10mg

Salbutamol 100mg (inhalar)

Morphine sulphate 10mg tablets

MidazolamGlucagonGlucose or dextrose

10mg1mg (ampoules)50% (injection)

Drugs

Dental assistant: Maintain A B C of CPR. Place Pt in supine position. Assess and record vital signs. Dental Hygienist: Bring emergency kit\oxygen to chair side. Prepare medication for dentist. Dentist: Direct other team member and overall

treatment. Administer emergency medications.

Sample emergency assignment for dental

office

THANK YOU