Chapter 1

Question 1

What is the most common emergency in the dental office?

Answer 1

Syncopy (50%)

Question 2

Name the 3 most common dental emergencies other than syncope?

Answer 2

Angina pectoris (8%) Orthostatic hypotension (8%) Mild allergic reaction

Question 3

When are medical emergencies most likely to occur in the dental office?

Answer 3

Local anesthetics Extraction Endodontics

Question 4

True or False Approximately 1/3 of all the medical emergencies in the dental office are potentially life threatening.

Answer 4

True

Question 5

True or False Due to the increasing age of the patient population as well as advances in health care (such as pharmaceuticals, surgery, and life prolonging treatments) there will be an increase in the amount of dental emergencies seen in the dental setting.

Answer 5

True

Question 6

What conditions may a medical history include?

Answer 6

Heart conditions Myocardial infarctions Congestive heart failure Cerebrovascular accident (be alert to possible CVA) Asthma (be alert to possible asthma attack) Stroke Frequent headaches Dizziness Epilepsy (be alert to seizures) Thyroid problems (be alert to myxedema coma, thyroid storm) Diabetes (be alert to hypoglycemia or diabetic coma) Corticosteroid use (be alert to signs of adrenal insufficiency) Allergies (be alert to allergic reaction) Bleeding disorders (be alert to signs of bruising, hemorrhage, or hemophilia)

Question 7

What do vital signs include?

Answer 7

Pulse Respiration Blood pressure Temperature

Question 8

What is tachycardia?

Answer 8

> 100 BPM

Question 9

What is bradycardia?

Answer 9

< 60 BPM

Question 10

What is tachypnea?

Answer 10

Abnormally fast respiratory rate

Question 11

What is bradypnea?

Answer 11

Abnormally slow respiratory rate

Question 12

What is dyspnea?

Answer 12

Labored breathing

Question 13

What is ASA I?

Answer 13

Normal, healthy patient Can walk up two flights of stairs or walk two city blocks without shortness of breath

Question 14

What is ASA II?

Answer 14

Mild systemic disease Can walk up one flight of stairs or walk two city blocks but may have shortness of breath upon completion

Question 15

What is ASA III?

Answer 15

Sever systemic disease that limits activity but is not incapacitating Can walk up one flight of stairs or walk one city block, but may stop during the walk due to shortness of breath

Question 16

What are the symptoms of ASA II?

Answer 16

Adult onset diabetes Epilepsy Hypotension Uncontrolled asthma Severe allergies Pregnancy

Question 17

What are the symptoms of ASA III?

Answer 17

Unstable angina Myocardial infarction longer than 6 months ago with no signs and symptoms Well-controlled diabetes Congestive heart failure (CHF) Blood pressure 160/65

Question 18

What is ASA IV?

Answer 18

Systemic disease that is incapacitating Constant threat to life Unable to walk up a flight of stairs or one city block May have shortness of breath or distress at rest

Question 19

What are the symptoms of ASA IV?

Answer 19

Myocardial infarction within the past 6 months Unstable angina Blood pressure > 200/115 Congestive heart failure Uncontrollable diabetes Uncontrolled epilepsy

Question 20

What are the symptoms of ASA V?

Answer 20

Moribund patient Not expected to survive after 24 hours without operation Poorly controlled coagulopathy Sepsis with hemodynamic instability Proceed number with E (in event of emergency operation)

Question 21

What are the symptoms of ASA VI?

Answer 21

Declared brain dead patient whose organs are being harvested for donation

Question 22

Which ASA type patient is more likely to experience a medical emergency?

Answer 22

ASA PS III

Question 23

Hypoxia patients’ skin tone turns which color?

Answer 23

Bluish tone

Question 24

Hypertensive patients’ skin tone turns which color?

Answer 24

Appear flushed or red

Question 25

What preparations should be made by the dental office to prepare for medical emergencies?

Answer 25

Well-equipped medical emergency kit with oxygen tank Current CPR training Attendance at CE courses on medical emergencies In-office simulated medical emergencies

Question 26

What is P 1 emergency team structure?

Answer 26

Person in whose operator emergency is occurring Stays with patient Performs emergency procedure

Question 27

What is P 2 emergency team structure?

Answer 27

Next most available person Assists P1 Responsible for vital signs and application of oxygen Records events and informs P1 of time elapsed since medication delivered

Question 28

What is P 3 emergency team structure?

Answer 28

Next available person Retrieves emergency kit Prepares emergency drugs for P1

Question 29

What is the order of the emergency team structure?

Answer 29

P1 P2 P3 Office receptionist

Question 30

What is the R.E.P.A.I.R system?

Answer 30

Recognize the signs and symptoms of emergencies and stop all treatment Evaluate the patients level of consciousness Place the patient in the appropriate position Activate the CABS of CPR by checking the circulation, airway, and breathing Implement the appropriate emergency protocol for the specific emergency Refer the patient to the appropriate healthcare professional if necessary Don’t hesitate to call 911 if unsure

Question 31

What percentage of dental emergencies are syncope?

Answer 31

50%