Emergencies & Records - Week 12 PP

Question 1

Medical Emergencies

Answer 1

• A medical emergency is a condition or circumstance that requires immediate action for a person who has been injured or has suddenly become ill
• You must be prepared to respond immediately
• Your knowledge and skills could mean the difference between life and death

Question 2

Key to prevent a medical emergency is…

Answer 2

-Have open communication about patient’s health

• Ensure medical history is updated at every appointment
• most emergencies that occure in the dental office are caused by the combined stress of a person’s daily life and the apprehension of going to the dentist

Question 3

Successful management of medical emergencies in the dental office requires..

Answer 3

-Preparedness
-Prompt recognition
-Effective treatment

• Ongoing observation of the patient is an important part of emergency preparedness

Question 4

A symptom is..

Answer 4

..is what the patient is telling you about how she or he feels or what he or she is experiencing.. such as “I feel dizzy”, “I’m having trouble breathing” or “my arm hurts”

Question 5

A sign is…

Answer 5

..is what you observe in a patient, such as a change in skin colour, or increas in respiratory rate

Question 6

Roles..

Answer 6

When an emergency occurs in the dental office, it is most effectively managed when each member of the dental team executes his or her responsibilities efficiently. It is for this reason that each member of the team be assigned specific responsibilities, such as:
◦ Comforting the patient
◦ Monitoring the patient’s vital signs
◦ Retrieving the emergency kit
◦ Bringing the oxygen tank
◦ Calling emergency services
◦ Responding to the needs of other patients in the office

Question 7

Calling for Help

Answer 7

• a list of emergency numbers including emergency medical services (EMS), police, and firefighteres should be posted at each phone
• all three services can be obtained by dialing 911

Question 8

Every member of the dental team must be current in..

Answer 8

-Basic Life Support
*Heimlich maneuver / Chest Thrusts
*AED

• Abilitiy to assess and record vital signs accurately

Question 9

Postural Hypotension

Answer 9

• also referred to as orthostatic hypotension, is a level of altered consciousness that may lead to a loss of cosciousness
• postural hypotension results from insufficient blood floor to the brain and may occur in a patient immediately after a sudden change in position

Question 10

Syncope

Answer 10

is caused by an imbalance in the distribution of blood to the brain and
to the larger vessels within the body. This reduced blood flow to the brain
causes the patient to lose consciousness

Question 11

Syncope Psychological Factors

Answer 11

Psychological factors that can contribute to syncope include stress, apprehension, fear, and
the sight of blood or the sight of a certain instrument

• Physiologic factors can include remaining in one position for a long time, being in a confined
  environment, skipping a meal or being hungry, and experiencing fatigue or exhaustion. The
  patient may complain of symptoms, and the signs may be noticed for several minutes before the patient loses consciousness `

Question 12

Syncope Prevention

Answer 12

• IF a patient tells you they feel like they may faint:
• seat them in a supine position
  -lie them down and elevate patient’s legs

Question 13

Management of Syncope Emergency

Answer 13

1. Place the patient in a supine position and elevate their legs about 10-12 inches.
2. Loosen binding clothing.
3. Have ammonia inhalant ready to be administered.
4. Have oxygen ready to be administered.
5. Monitor and record the patient’s vital signs.
6. If unresponsive, call for emergency assistance (911)

Question 14

Angina

Answer 14

• Term used for chest pain caused by insufficient blood supply or oxygen to the heart
• can be aggravated by stress, excercise, tension, cold weather or a large meal

Question 15

Angina attack

Answer 15

-the patient feels severe chest pain
-sensation of severe constriction or pressure on the chest
-the signs and symptoms of angina and those of myocardial infarction are very similar
-Anginal pain usually lasts 3 to 8 minutes
-Pain is relieved or eased promptly by the administration of the commonly prescribed drug, nitroglycerin
- When an attack strikes, it is important to remember that the patient could be having a heart attack

Question 16

Management of Angina Emergency

Answer 16

1. Call for emergency assistance (9-1-1).
2. Position the patient upright.
3. Medicate with nitroglycerin (tablets, spray, or topical
   cream).
4. Administer oxygen.
5. Monitor and record vital signs

Question 17

Myocardial Infarction

Answer 17

Commonly referred to as a heart attack
◦ The muscles of the heart are damaged because of an
insufficient oxygen supply
◦ If this damage is severe enough, the patient will die;
however, prompt medical treatment can limit damage to
the heart
◦ Any unexplained chest pain should be treated as a
potential acute myocardial infarction

Question 18

Management of Heart Attack Emergency

Answer 18

1. Call for emergency assistance (9-1-1).
2. Initiate basic life support (CPR) if the patient becomes
   unconscious.
3. Ready the nitroglycerin from the office’s emergency kit.
4. Administer oxygen.
5. Monitor and record vital signs

Question 19

Allergic Reactions

Answer 19

• an altered state of reactivity that occurs in body tissues in response to specific antigens. An antigen is a substance that causes an immune response through the production of antibodies
• an antigen that can trigger the allergic state is known as an allergen

Question 20

Allergic Reactions - Important Factors

Answer 20

(1) the speed with which symptoms appear and
(2) the severity of the reaction. A localized allergic response is usually slow to develop. Mild
symptoms typically include itching, erythema, and hives

Question 21

Managemet - Localized reaction

Answer 21

1. Identify area of rash.
2. Monitor and record vital signs.
3. Prepare an antihistamine for administration if
   necessary.
4. Be prepared to administer basic life support (CPR)
   if necessary.
5. Refer the patient for medical consultation.

Question 22

Managemet of Anaphylaxis Emergency

Answer 22

1. Call for emergency assistance (9-1-1).
2. Place the patient in a supine position.
3. Start basic life support (CPR) if the patient
   becomes unconscious.
4. Prepare EpiPen for administration.
5. Administer oxygen - ASSISTANT CANNOT ADMINISTER - they can prepare only (Board exam)
6. Monitor and record vital signs

Question 23

Hyperventilation

Answer 23

• This medical emergency can occur when a patient is extremely anxious or apprehensive before undergoing dental treatment
• to prevent or reduce hyperventilation, the dental team should always be alert and be prepared to help the patient deal with severe apprehension in a positive manner

Question 24

Hyperventilation Management

Answer 24

1. Place the patient in a comfortable position.
2. Use a quiet tone of voice to calm and reassure the patient.
3. Have the patient breathe into his or her cupped hands
   NOTE Some sources will indicate to breathe into a paper bag, but a patient’s cupped hands have been found to be better.
   PURPOSE This response increases the carbon dioxide supply and restores appropriate oxygen and carbon dioxide levels in the blood

Question 25

Asthma

Answer 25

• patients with asthma generally carry an inhaler that contains medication (bronchodilator) to releive the first symptoms of an atttack. It is essential that asthma be identified on the patient’s medical history, and that the patient brings his or her inhaler to each dental appointment

Question 26

Asthma Emergency Management

Answer 26

1. Call for assistance.
2. Position the patient as comfortably as possible
   (upright is usually best).
3. Have patient self-medicate with an inhaler.
4. Administer oxygen as needed.
5. Assess and record vital signs

Question 27

2 Types of Seizures

Answer 27

1. Generalized (Grand Mal)
2. Partial (Petit Mal)

Question 28

Generalized Seizure Emergency Management

Answer 28

1. Call for emergency assistance (9-1-1).
2. If a seizure occurs while the patient is in the dental chair, quickly remove all materials and
   dental instruments from the mouth and place the patient in a supine position.
3. Protect the patient from self-injury during movements caused by the convulsion.
4. Prepare anticonvulsant (diazepam) from the drug kit if necessary.
5. Initiate basic life support (CPR) if necessary.
6. Monitor and record vital signs

Question 29

F.A.S.T - for Stroke

Answer 29

F = Face Drooping
A = Arm Weakness
S = Speech Difficulty
T = Time to call 911

Question 30

Diabettes

Answer 30

Hyperglycemia - results from an abnormal increase in the glucose (sugar) level in the blood

Hypoglycemia - results from an abnormal decrease in the glucose level in the blood

Question 31

Hyperglycemia

Answer 31

1. If the patient is conscious, ask when he or she last ate, whether the patient has taken insulin, and whether he or she brought insulin along to the dental appointment.
2. Retrieve the patient’s insulin if it is available. If able, the patient should self-administer the insulin.
3. Call for emergency assistance (9-1-1) if necessary.
4. Provide basic life support (CPR) if the patient becomes unconscious.
5. Monitor and record vital signs.

Question 32

Hypoglycemia

Answer 32

1. If the patient is conscious, ask when he or she last ate, whether he or she has taken insulin, and whether he or she brought insulin along to the dental appointment.
2. Give oral glucose from emergency kit or a concentrated form of carbohydrate, such as a
   concentrated orange juice.
3. Call for emergency assistance (9-1-1) if necessary.
4. Provide basic life support (CPR) if the patient becomes unconscious.
5. Monitor and record vital signs.

Question 33

7 Emergency Drugs in Dentistry

Question 34

Documentation of an Emergency

Answer 34

• full documentation of the details of an emergency is essential
• after such an emergency, the dentist willl make extensive notes in the patient’s record to:
  *Explain exactly what happened
  *indicate the treatment provided
  *describe the patient’s condition at the time he or she left the office