Medical Emergencies in Dentistry Flashcards
(28 cards)
What should you pay attention to when observing the general physical condition of the patient
- Patient’s Posture
- Body movements
- Quality of speech
- Feel of the patient’s skin
- Colour of the patient’s skin
- Odours on the breath
- Rate and pattern of respiration
What basic ME skills should the dental team be trained to do (minimum requirements)
- BLS (basic life support)
- CPR
- Use of AED
- Use of self inflating bag and mask devices
What should be available to the dental team as part of preparation for MEs
- Easy and quick access to emergency drugs and equipment
- Plan to summon medical assistance
- Where possible drugs in solution should be in a pre-filled syringe
Give examples of how Medical Emergencies are classed systemically
- Cardiovascular emergencies
- Respiratory emergencies
- Neurological emergencies
- Metabolic emergencies
- Miscellaneous
Give examples of cardiovascular emergencies
- Myocardial Infarction
- Angina
- Cardiac Arrest
- Syncope (fainting)
- Postural Hypotension
Give examples of Respiratory emergencies
- Hyperventilation
- Respiratory Arrest
- Acute Respiratory Obstruction: Inhaled foreign body
- Asthma
Give examples of Neurological emergencies that you may encounter in the GD practice
- CVA (stroke)
- Status epilepticus
- Loss of consciousness
Give examples of metabolic emergencies you may encounter in the GD practice
- Hypoglycaemia
- Hyperglycaemia
- Addisonian crisis
Give some examples of the drug related (miscellaneous) emergencies
- Anaphylaxis
- Drug overdose
- Drug allergy
- Drug interactions
Describe the dose, route and mechanism of the drug you use for an Angina ME
Glyceryl Trinitrate Spray
Dose: 400 microgram/activation
Route: Sublingual
Mechanism: Potent vasodilator
Describe the dose, route and mechanism of the drug you use for an Asthma ME
Salbutamol Aerosol Inhaler
Dose: 100 microgram/activation
Route: Inhalation
Mechanism: B2 agonist
Describe the dose, route and mechanism of the drug you use for an Anaphylaxis ME
Adrenaline (1mg/ml)
Dose: 0.5 mg
Route: Intramuscular
Mechanism: Alpha receptor agonist, B1 agonist, B2 agonist, Mast cells stabilisation, Glucose elevation
Describe the dose, route and mechanism of the drug you use for a myocardial infarction ME
Aspirin Dispersable
Dose: 300mg
Route: Oral
Mechanism: Antiplatelet
Describe the dose, route and mechanism of the drug you use for an Unconscious hypoglycaemia ME
Glucagon
Dose: 1mg
Route: Intramuscular
Mechanism: Glycogenolysis
Describe the dose, route and mechanism of the drug you use for a conscious hypoglycaemia ME
Glucose solution/tablet/gel/powder
Dose: -
Route: Oral
Mechanism: -
Describe the dose, route and mechanism of the drug you use for an epilepsy (status epilepticus) ME
Midazolam
Dose: 10mg/ml
Route: Buccal
Mechanism: Muscle relaxant
Describe the dose, route and mechanism of the drug you use for a syncope, MI, Stroke, anaphylaxis, epilepsy and adrenal insufficiency MEs
Oxygen
Dose: 15L/min
Route: Inhalation
Name some medical emergency equipment that needs to be available in a GD practice
- Portable oxygen cylinder
- Oxygen face mask with reservoir and tubing
- Pocket mask with oxygen port
- Basic set of oropharyngeal airways
- Self inflating bag and mask apparatus
- Adult and child face masks for use with self-inflating bag
- Portable suction e.g. yankauer sucker
- Single use sterile syringes, needles and protective equipment (gloves, aprons, eye protection)
- Spacer device for inhaled bronchodilators
- Automated blood glucose measurement device
- Automated external defibrillator (AED)
What does ABCDE stand for when trying to assess and treat a patient in an ME
Airway Breathing Circulation Disability Exposure
Name a few of the general principles of managing MEs
- Treat life-threatening problems as they are identified before moving to the next part of the assessment
- Assess the effects of any treatment given (can take a few mins to work)
- Continually re-assess starting with airway if there is further deterioration
Name a few of the signs for airway obstruction
- Paradoxial chest and abdominal movements
- Use of accessory muscles of respiration
- Central cyanosis in late stage
- In partial obstruction - stridor, wheeze, gurgling or snoring may be noticed
- In complete obstruction - no breath sound possible
What needs to be done in the case of airway obstruction
- Only simple methods of airway clearance needed in most cases
- Open airway - head tilt/chin lift or jaw trust
- Can use oropharyngeal airway adjuncts
- In some cases give O2 at 15L/min flow rate
What are the most common breathing problems in the GD practice
Hyperventilation and panic attacks - both tend to resolve with simple reassurance
How do you measure/observe the circulation of the patient
- Check the colour of the hands and fingers
- Assess limb temperature by the patient’s hand - cool of warm?
- Measure the capillary refill time
- Count the patient’s pulse rate
- Weak pulses + decreased conscious level + slow capillary refill time suggests low BP
