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Med Emergencies > Med Prevention > Flashcards

Med Prevention Flashcards

1
Q

how many dentists report med emergencies?

A

96.6%

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2
Q

where do med emergencies happen? who do they happen to?

A

mainly in treatment area before or after local is given, but can happen anywhere and to ANYONE in the building

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3
Q

what are the top 3 emergencies?

Other common ones?

A

1) seizures
2) syncope
3) hyperventilation
* hypoglycemia, postural hypotension and allergic reactions are also common

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4
Q

what dental treatment most often associated with emergencies?

A

tooth extraction or pulp extirpation (bc they cause high stress)

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5
Q

what are factors that increase the number of emergencies?

A

1) increasing number of geriatric patients
2) advances in medical treatment
3) longer dental appointments
4) increased use of drugs

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6
Q

increasing number of geriatric patients with?

A

retained teeth

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7
Q

what is the greatest concern with geriatric patients?

A

cardio system

  • patient may be asymptomatic
  • stress can trigger acute event (older patients do not handle stress as well)
  • clinically evident as congestive heart failure
  • significant disease of subclinical nature may be present
  • organ systems begin to deteriorate
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8
Q

What is the number one cause of death for people over 65?

A

cardiovascular disease

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9
Q

how does advances in medical treatment lead to more med emergencies?

A

patients are living longer but not healthier, still have serious diseases which increases their risk of emergency

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10
Q

how does increased use of drugs lead to more med emergencies?

A

increase multiple medications = increase risk of drug interactions and unwanted side affects

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11
Q

how many patients over 60 take one or more medications?

A

41%

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12
Q

what is the problem based approach?

A

1) recognize and ID the significant features
2) initiate treatment to stabilize the immediate event
3) secondary steps to obtain definitive diagnosis

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13
Q

goals of doing “medical history” updates at every appointment?

A

1) determine the patients ability to physically and psychologically tolerate stress of the planned treatment
2) determine if modifications to the treatment are required
3) determine if some form of sedation is necessary

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14
Q

what % of life threatening situations can be prevented?

A

90%

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15
Q

medical history is considered a ____ tool for dentist? Positive responses require what?

A

screening

* any POSITIVE response will require more direct questions and physical examination to thoroughly evaluate the patient

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16
Q

pre-med for anything that goes into the?

A

sulcus

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17
Q

how much amoxicillin should a person take before the appointment?

A

2g about 1 hr before

*** children are 50 mg

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18
Q

what do you prescribe if NOT allergic to penicillin?

A

cephalexin, cephradine, amoxicillin 2grams 1hour pre-op

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19
Q

what do you prescribe IF allergic to penicillin?

A

clindamycin 600 mg orally 1 hour pre-op

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20
Q

when is dental treatment safely done with kidney hemodialysis?

A
  • day AFTER dialysis
  • or a minimal of 8 hours later
  • prophylactic antibiotics if arteriovenous shunt present
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21
Q

COPD stands for? problems this causes?

A

chronic obstructive pulmonary disease

** decreased respiratory reserve** so be careful with respiratory depressing medications

22
Q

patients with COPD typically need?

A

supplemental oxygen at a low flow because of hypoxic drive

23
Q

3 reasons we take vital signs?

A

1) ID undiagnosed diseases
2) subsequate values can be compared to ID trends
3) useful for comparison in times of emergency

24
Q

how to take BP?

A
  • patients seated upright
  • left arm relaxed, slightly flexed on flat surface at lever of heart
  • appropriate size cuff
  • allow patient time to relax
  • establish palpatory systolic pressure on first time patients
  • gradually deflate cuff pressure
25
Q

loose application of correcly fitting cuff gives?

A

false elevated readings

26
Q

cuff that is too small =

A

false elevated reading

27
Q

cuff that is too big=

A

false decreased readings

28
Q

cuff size for BP should be?

A

20% greater than diameter of arm

29
Q

what is optimal BP?

A

120/80

30
Q

what is auscultory gap?

A
  • infrequent
  • sound loss between systolic and diastolic
  • can prevent by using systolic palpatory technique
  • ** do NOT use a bouncing needle
31
Q

UNMC COD will perform an examination ONLY when BP is between?

A

165/95 and 180/105

32
Q

where do you check the heart rate in an emergency and non-emergency situation?

A

NON= brachial in elbow and radial in wrist

emergency= carotid in neck

33
Q

normal range for heart rate?

A

60-110 bpm

34
Q

skipped heartbeats could represent?

A

premature ventricular contractions (PVCs)

35
Q

when should you consult for premature ventricular contractions (PVCs)?

A

if there are more than 5 per minute

* PVCs are common and can be from smoking, fatigue, stress, medications and alcohol

36
Q

irregular rhythm could indicate?

A

atrial fibrillation and heart block

37
Q

pulsus alternans

A

alternating strong and weak beats

- seen in LEFT ventricular failure, severe arterial high blood pressure and coronary artery disease

38
Q

what is a normal respiratory rate?

A

12-20 breaths

39
Q

What is Corah?

A

a dental anxiety scale

40
Q

list signs of anxiety

A
  • patients remain alert
  • sit on edge of chair
  • eyes roam the room and watch you
  • appear unnaturally stiff/tense
  • white knuckles/ clenching
  • nervous play
  • cold, sweaty palms, sweating
41
Q

how many anxious patients avoid dental appointment? How many visit occasionally and show anxiety?

A

6-14% avoid dental appointment

20-30% only occasionally visit and exhibit signs of anxiety

42
Q

ASA 1

A
  • what we WANT
  • normal and healthy
  • no treatment modifications needed
  • patient can walk up stairs
43
Q

ASA 2

A
  • mild systemic disease
  • ASA 1 with EXTRME anxiety
  • minimal risk
  • slight modifications
  • patients can walk up stairs
44
Q

examples of ASA 2

A
  • well controlled type 2 diabetes
  • well controlled epilepsy
  • well controlled asthma
  • ASA 1 with respiratory infection
  • healthy prego woman
  • multiple allergies
  • healthy but over 60
45
Q

ASA 3

A
  • sever systemic disease that limits acitivity but is not incapacitating
  • no symptoms at rest
  • may exhibit symptoms when experiencing physiological or psychological stress
  • can still walk up stairs but need a rest
  • implement stress reduction protocols
46
Q

examples of ASA 3

A
  • stable angina
  • MI orCVAmorethan 6 months
  • contolled type 1
  • congestive heart failure with ankle edema
  • COPD
  • excercise asthma
  • bad epilepsy
  • symptomatic hypo/hyperthyroid
47
Q

ASA 4

A
  • incapacitating systemic disease that is a constant threat to lide
  • SYMPTOMS AT REST
  • can’t get up stairs
  • NO ELECTIVE TREATMENT
  • emergencies treated with analgesics and antibiotics, invasive at hospital
48
Q

examples of ASA 4

A
  • unstable angina
  • MI and CVA within past 6 months
    BP > 200 or 115 mHG
  • severe CHF or COPD
  • uncontrolled epilepsy or type 1 diabetes
49
Q

bodies release ____ in repsonse to stress in pain.

A

catecholamines

50
Q

catecholamines do what?

A

increase heart rate, strength of myocardial contraction and oxygen requirment

51
Q

physiologic and psychologic stress?

A 
physiologic 
- pain
- excercise
psychologic
- anxiety
- fear

Med Emergencies (4 decks)

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