Medical emergencies

Question 1

Management of mild urticaria/angiodema?

Answer 1

Stop dental tx
Remove allergen
Recommend oral antihistamine

Question 2

Extensive urticaria or angiodema or swelling involving eyelids, lips and tongue

Answer 2

Stop dental tx
Remove allergen
Refer for urgent medical attention, systemic corticosteroids may be indicated

Question 3

What is anaphylaxis characterised as?

Answer 3

Severe bronchospasm
Upper airway obstruction
Hypotension

Question 4

Anaphylaxis management?

Answer 4

Stop tx
Remove allergen, lie pt flat

Give epipen
- adrenaline intramuscularly 300mcg (child more than 20kgs)
Child 10-20kg 150mcg
OR
- 10mcg/kg up to 500 mcg

Call 000
Supplemental oxygen and CPR if needed
Repeat adrenaline every 5 mins until pt responds or help arrives.

Question 5

Anaphylaxis management?

Answer 5

Stop tx
Remove allergen, lie pt flat

Give epipen
- adrenaline intramuscularly 300mcg (child more than 20kgs)
Child 10-12kg 150mcg
OR
- 10mcg/kg up to 500 mcg

Call 000
Supplemental oxygen and CPR if needed
Repeat adrenaline every 5 mins until pt responds or help arrives.

Question 6

What is vasovagal syncope?

Answer 6

reaction to pain, or to anxiety and fear before, during or after a dental procedure

Question 7

If pt feels faint

Answer 7

Stop tx, put pt in horizontal position, raise legs
Measure heart rate, assess consciousness

Question 8

If pt faints

Answer 8

Stop tx
Raise legs
Measure BP and heart rate

If pt does not recover
Call 000
Start basic life support
Place pt on side

Question 9

Signs of acute coronary syndrome?

Answer 9

Crushing
Heavy central radiating chest pain, goes to jaw, arm, back
Shortness of breath, nausea and sweating.

Question 10

What is stable angina?

Answer 10

Chest discomfort that lasts 10 minutes or less
Subsides promptly with rest
Triggered by stress or physical activity

Question 11

Management of stable angina?

Answer 11

Stop tx
Measure BP, heart rate, PO
Give GTN
- 400mcg spray, repeat every 5 mins if pain, up to 3 doses
- 300-600 tablet, every 5 mins if pain, up to 3 doses

Question 12

What if angina pain persists for more than 10 mins despite 2 doses?

Answer 12

Chest pain is now severe
Give another GTN dose
Call 000
Give aspirin 300mg
Measure vitals
Loses consciousness - basic life support, defib

Question 13

What is a cardiac arrest and what to do?

Answer 13

Loses consciousness, no pulse, no breathing. Call 000, CPR, defib

Question 14

Hypoglycamia glucose concentration?

Answer 14

Below 4mmol/L

Question 15

Symptoms of hypoglycaemia?

Answer 15

Adrenergic - pale skin, sweating, shaking, palpitations
Neuroglycopenic - hunger, difficulty concentrating, confusion and inappropriate behaviour, loss of consciousness, seizures.

Question 16

Management of hypoglyceamia?

Answer 16

Stop tx
Give 15g adult
Child older than 6 10g
Child younger than 5 5g
After 15 mins, check glucose again. If no improvement give more.
if 3 or more doses, recommend to see GP

Question 17

Hyperglycemia signs?

Answer 17

Stomach pain
Nausea
Vomiting

Question 18

Signs of a stroke?

Answer 18

Face
Arms
Speech
Time

Question 19

What to do if stroke?

Answer 19

Stop tx
Call 000
Measure vitals
Give oxygen if below 90%
DO NOT GIVE ASPIRIN

Question 20

Managing a seizure?

Answer 20

Stop tx
Wait until seizure stops
Assess consciousness, suction vomit.

Question 21

If seizure lasts for a few minutes or repeated seizure attacks occur without recovery of conciousness?

Answer 21

Status epilepticus
Call 000
Maintain airway
Wait until assistance arrives

Question 22

Asthma attack management?

Answer 22

Mild -moderate
Give 4 puffs salbutamol inhaler
4 spacer breaths
Wait 4 mins
If no improvement repeat 4puffs

If no improvement and severe:
Call 000
Give adult and 6 or above 12 puffs
Below 6, 6 puffs
If life-threatening, give salbutamol continuously.