Emergencies in the dental office

Question 1

each dentist will experience how many life threatening emergencies in his/her career

Answer 1

1-2

Question 2

Prepareathon

Answer 2

FEMA put it on to motivate people and communities to take action to prepare for and protect themselves against disasters

Question 3

Category 1 Emergency

Answer 3

MINOR

simple faint

trendelenburg position - body is laid supine with a 15-30 degree incline with the feet elevated above the head

Question 4

Category 2 Emergency

Answer 4

INTERMEDIATE

O2 and repositioning

Question 5

Category 3 Emergency

Answer 5

MAJOR

referral to MD or hospital ER

Question 6

Prevention of medical emergencies

Answer 6

good medical history

VITAL SIGNS
blood pressure less than 120/80
heart and rhythm 60-100
respiratory rate 12-20
height
weight

Question 7

levels of consciousness

Answer 7

awake

altered - pre-syncope ; TIA (mini stroke)

unconscious - syncope (faint) orthostatic hypotension

seizures - hyperventilation ; syncope ; epilepsy

Question 8

Airway and breathing problems

Answer 8

obstruction

hyperventilation

asthma

COPD (chronic obstructive pulmonary disease) ; Emphysema

Question 9

Cardiovascular problems

Answer 9

angina - chest pain

hypo/hypertension

dysrhythmia - bradycardia tachycardia

myocardial infarction

cardiac arrest

Question 10

Drug related problems

Answer 10

Overdose
local anesthetics
sedatives

Reaction to drugs
allergy (rash itching airway)

Question 11

Stress reduction protocol

Answer 11

oral sedation (valium)

intraoperative sedation

effective pain control (give good shots NO ZINGS)

AM appointment (better for physiological reasions)

Short appointments

post-op RX

Post op phone call to check on pt

Question 12

Syncope

Answer 12

a transient loss of consciousness due to hypoperfusion of the brain and is characterized by raid onset and spontaneous resolution

bradycardia
rapid fall in blood pressure

evoked by emotional stress associated with fear or pain

Question 13

orthostatic hypotension

Answer 13

decrease in systolic blood pressure of 20 mmHg

OR

a decrease in diastolic pressure of 10 mmHg

within 3 minutes of standing

increases with age

Question 14

syncope recover time

Answer 14

complete recovery takes 24 hours

decide whether to continue treatment or reschedule

Question 15

what can contribute to syncope

Answer 15

upright or stand positions for extended period of time

hunger

exhaustion

poor physical condition

hot humid crowded environment

Question 16

Vasovagal syncope

Answer 16

sudden rapid drop in HR and BP which leads to fainting

most common cause of syncope 32%

most patients experience their first episode as a teenager or adolescent

Question 17

Syncope manifestations

Answer 17

warmth

loss of color

sweating

feels bad

nausea

BP at baseline

Tachycardia

Question 18

Late syncope manifestions

Answer 18

yawning

difficult breathing

pupillary dilation

cold hands and feet

dizziness

loss of consciousness

hypotension

bradycardia

Question 19

Syncope treatment

Answer 19

postion patient horizontal

airway breathing

circulation - vital signs

oxygen

COOL COMPRESS

loosen clothing

reassurance

Question 20

Hyperventilation

Answer 20

to breathe at an abnormally rapid pace so increasing the rate of loss of carbon dioxide

women experience more than men

Question 21

hyperventilation signs and symptoms

Answer 21

rapid and shallow breathing

rapid pulse and respiration

confusion / dizziness

cold hands

tightness in chest / pain

carpal pedal spasms (due to reduced Ca2+ levels messing will cell signaling)

Question 22

Hyperventilation management

Answer 22

terminate procedure

position comfortably (usually upright)

reassure patient

no oxygen

breathe into paper bag or CUPPED HANDS

count to 10 between breaths

valium 5mg IM or IV for severe cases