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dh theory > Management of Common Medical Emergencies > Flashcards

Management of Common Medical Emergencies Flashcards

1
Q

Factors that Increase the Likelihood of Emergencies

A
  • Increased number of medically
    compromised individuals seeking care
  • Medical advances in drug therapy
  • Longer appointments
  • Increased use of drugs in oral healthcare
    settings
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2
Q

Prevention

A
  • Comprehensive health history and risk
    assessment
  • Treatment Modification
  • Documentation
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3
Q

Health Assessment

A

Vital Signs

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3
Q

Health History

A
  • Past and present health status
  • Problems a patient might not be aware of
  • List of medications names and dosages
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4
Q

What are common signs of anxiety in dental patients?

A

*Sweating
*Increased blood pressure and heart rate
*Restlessness
*Nervous conversation
*History of cancelled appointments
*Only seeking ER care.

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5
Q

What are some effective stress reduction strategies for anxious dental patients?

A

*Building rapport
*Clear communication
*Minimizing wait time
*Scheduling short morning appointments
*Pain control
*Providing follow-up care.

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6
Q

Physical Status Classification

A

American Society of Anesthesiologists (ASA)

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6
Q

ASA I

A

(green): normal health

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7
Q

ASA II

A

(yellow): mild disease/extreme anxiety

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8
Q

ASA III

A

(yellow): severe disease

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9
Q

ASA IV

A

(red): disease threatens life

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10
Q

ASA V

A

(red): near death

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11
Q

ASA VI

A

(red): moribund

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12
Q

How should dental personnel be prepared for emergencies?

A

Trained to recognize and assist in emergencies.

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13
Q

What training should dental personnel have for emergency situations?

A
  • BLS, CPR, AED
  • Drills
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14
Q

What is the role of the emergency kit in the dental office?

A

Should be readily available and include necessary supplies to manage emergencies and summon EMS, directing them to the scene.

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15
Q

What are the contents of the Emergency Kit

A
  • Epinephrine
  • Histamine blocker
  • Nitroglycerin
  • Bronchodilator
  • Oral glucose
  • Aspirin
  • Pulse oximeter
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16
Q

What are common causes of unconsciousness in dental patients?

A

Vasovagal syncope and orthostatic hypotension.

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17
Q

What are common respiratory distress emergencies in dentistry?

A

Hyperventilation, asthma, and allergy/anaphylactic reactions.

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17
Q

What are common causes of altered consciousness in dental patients?

A

Hypoglycemia and seizures.

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18
Q

What are the signs of chest pain emergencies in dentistry?

A

Angina pectoris and acute myocardial infarction.

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19
Q

What is vasovagal syncope?

A

“Simple fainting,” a sudden, temporary loss of consciousness with a maintained pulse.

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20
Q

How does vasovagal syncope typically present?

A

The patient experiences a sudden loss of consciousness, but their pulse remains steady.

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21
Q

What are the signs and symptoms of syncope?

A

Pallor, light-headedness, and sweating.

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22
Q

How should you treat syncope in the dental office?

A

*Lay the patient supine
*Elevate their lower extremities
*Monitor vital signs.

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23
Q

Should ammonia ampules be used to treat syncope?

A

They are unnecessary

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24
Q

What should you do if syncope symptoms do not resolve?

A

Call 911 for emergency medical assistance.

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25
Q

How can you identify a patient at risk for syncope?

A

Patients prone to anxiety or those using anti-anxiety medications are at higher risk.

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26
Q

How should you position a patient to prevent syncope during treatment?

A

Keep the patient supine, especially during anesthesia administration.

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27
Q

What should you avoid to prevent syncope in patients?

A

Do not allow patients to change posture rapidly, especially elderly patients.

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28
Q

When is syncope not just “syncope”?

A

When the cause is more serious, such as a stroke, acute cardiovascular event, drug overdose, or hypo/hyperglycemia.

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29
Q

Other causes of altered consciousness:

A

– Vasovagal reaction
– Stroke
– Acute cardiovascular
event
– Self-induced drug
overdose
– Hypo- or
hyperglycemia

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30
Q

What typically precipitates hyperventilation?

A

Fear or anxiety.

31
Q

What happens during hyperventilation?

A

There is an excessive loss of carbon dioxide and inspiration of too much oxygen.

32
Q

What can happen if hyperventilation is not treated promptly?

A

It may lead to syncope.

33
Q

What are the signs and symptoms of hyperventilation?

A

– Air hunger, apprehension
– Rapid respiratory rate
– Circumoral, hand, and foot numbness or
tingling
– Carpopedal spasm
– syncope

34
Q

How should you treat hyperventilation?

A

Make the patient aware of their rapid breathing
Coach them to take slower breaths
Calm and reassure them.

35
Q

What should you do if a hyperventilation attack cannot be broken?

36
Q

Prevention of Hyperventilation: Stress reduction

A
  • Medical Risk
  • Morning clinic
  • Vital signs
  • Pain Control
  • Short sessions
  • Follow ups
37
Q

What is the most common cause of respiratory distress among dental patients?

38
Q

What happens during an asthma attack?

A

There is constriction of bronchial and bronchiolar muscles and excessive secretion of viscous mucus.

39
Q

What are the signs and symptoms of asthma?

A

– Wheezing
- Chest tightness
– Stridor
- Coughing
- Dyspnea
- Cyanosis

40
Q

How should you treat an asthma attack?

A
  • Position the patient in a tripod position
  • Administer one puff of an inhaler
  • Repeat in five minutes if needed.
41
Q

What should you do if there is no improvement in five minutes after treating asthma?

42
Q

How can you prevent asthma attacks?

A
  • Determine the severity of the illness
  • Medications prescribed
  • Frequency and severity of attacks, and known triggers.
43
Q

What can be done to reduce the risk of an asthma attack?

A
  • Remove allergens
  • Follow a stress-reduction protocol
  • Consult with a medical professional.
44
Q

What is hypoglycemia?

A

Low blood glucose levels, often caused by taking insulin without eating properly or taking too much insulin.

45
Q

Type I diabetes

A

The body does not produce adequate amounts of insulin.

46
Q

Type II Diabetes

A

Impaired glucose

47
Q

What are signs of hypoglycemia?

A
  • Altered mental status
  • Diaphoresis (sweating)
  • Tachycardia
  • Cold, clammy skin
  • Weakness, and lack of coordination.
48
Q

What can happen if hypoglycemia persists?

A

The patient may experience seizures and slip into a coma.

49
Q

How do you manage hypoglycemia in a conscious patient?

A

Give fruit juice or regular soda.

50
Q

How do you manage hypoglycemia in an unconscious patient?

A
  • Administer glucose gel, glucagon IM, or 50% dextrose IV.
  • Call 911 and provide basic life support.
51
Q

How can you prevent hypoglycemia in a patient?

A

Ensure blood sugar levels are controlled (80-100 mg/dl).

52
Q

What should a patient do before a dental appointment to prevent hypoglycemia?

A

Eat a meal after taking anti-diabetic medication.

53
Q

What causes an allergic reaction?

A

An antigen/antibody reaction to a substance the patient has been previously sensitized to.

54
Q

How can allergic reactions manifest?

A

Symptoms may be confined to a single organ or become generalized.

55
Q

What are the signs of a mild allergic reaction?

A

Flushed skin, swelling, rash (delayed response).

56
Q

How should an allergic reaction be treated?

A
  • Place the patient in a supine position and maintain the airway.
  • Administer Benadryl, steroids, or Epinephrine (EPIPEN).
  • Call 911 if necessary.
56
Q

What is the single leading cause of death in the U.S.

A

Cardiac Arrest/Myocardial Infarction

56
Q

What are the signs of a severe allergic reaction?

A

Respiratory distress, rapid onset, hypotension (anaphylaxis).

57
Q

How can allergic reactions be prevented in the dental office?

A
  • Review medical history for known allergies.
  • Assess the severity of the allergy.
  • Confirm the patient’s treatment plan for managing allergies.
58
Q

Cardiac Arrest/Myocardial Infarction

A
  • Supply of oxygenated blood to myocardium is reduced
  • Myocardial cells become necrotic
59
Q

What are common signs of cardiac arrest/myocardial infarction?

A
  • Squeezing sensation in the chest
  • Pain radiating to arms, neck, back, or jaw
  • Difficulty breathing
  • Perspiration and difficulty breathing
  • Nausea
  • Feeling of impending doom
60
Q

What is the first step in managing a Myocardial Infarction?

A

Terminate treatment.

61
Q

How should the patient be positioned during an Myocardial Infarction?

A

Position the patient comfortably, ideally in an upright position.

62
Q

What does MONA stand for in the treatment of Myocardial Infarction?

A
  • Morphine (IM/IV)
  • Oxygen
  • Nitroglycerin
  • Aspirin (325 mg, chewed)
63
Q

What if morphine is not available during an Myocardial Infarction?

A

Administer a 50:50 ratio of nitrous oxide and oxygen.

64
Q

How many doses of nitroglycerin can be given during an Myocardial Infarction?

A

3 doses within 10 minutes.

65
Q

What should be done if the patient is not responding to nitroglycerin?

A

Provide CPR and defibrillation if necessary.

66
Q

Why should dentists label the initial date when nitroglycerin is opened?

A

To track the expiration and ensure the medication is within its effective date.

67
Q

How should MI prevention be managed in dental settings?

A

Delay elective treatment until after 6 months post-MI

68
Q

What is necessary before proceeding with dental treatment for a patient with a history of MI?

A

Request medical clearance from the physician

69
Q

What blood pressure conditions should be avoided during dental treatment?

A

No treatment if blood pressure is excessively high

70
Q

Aspiration

A

Object enters the bronchi or lungs.

71
Q

Ingestion

A

Object enters the esophagus and GI tract.

72
Q

What are common dental objects that can be aspirated or ingested?

A
  • Extracted teeth
  • Crowns and bridges
  • Implant instruments, endodontic instruments
  • Cotton rolls
73
Q

Signs and Symptoms of Aspiration and/or Ingestion

A
  • Coughing
  • Airway Obstruction
74
Q

What position should a patient be placed in to manage aspiration/ingestion?

A

Upright position to encourage a productive cough.

75
Q

What imaging is used to manage aspiration or ingestion?

A
  • Flat plate X-ray of the abdomen
  • Chest X-ray
76
Q

What is the management for aspiration of an object?

A

Bronchoscopy to remove the object.

77
Q

What is the management for ingestion of an object?

A

Strain stools and xrays films in 3-4 days.

dh theory (9 decks)

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