Medical emergencies dentally relevant questions Flashcards
What ASA system would a dentist be expected to treat?
ASA 1 (healthy) to ASA 3 (severe systemic disease)
What are geudal airways used for?
Enable easier ventilation when doing ABCDE
How long do you listen to breathing when doing ABCDE?
10 seconds
What increase in blood volume does lying patient flat and raising legs when unconscious?
40% increase
If patient is struggling to breathe what position are they put in? and anaphylaxis exception?
Sat upright
Anaphylaxis - flat
What position should a pregnant woman be placed in a medical emergency and why?
Left lateral position
On right, inferior vena cava, therefore venous return will be worse
If flat, minimal venous return and will cause supine hypotension syndrome
In emergency anaphylaxis what should occur in dental practice?
How do the doses differ in children?
ABCDE
0.5ml 1:1000 sol. IM adrenaline in anterolateral thigh/ deltoid for 10 seconds
(<6months = 0.05ml, 6months-6yrs = 0.12ml, 6-12yrs = 0.25ml)
Repeat after 5 minutes if no change
Lie flat, maintain airway and give oxygen
How must carpal spasm and hyperventilation be managed?
Rebreathing exhaled air (more carbon dioxide) - using paperbag
What are the actions that need to be taken if an asthma attack were to occur in the dental chair?
ABCDE
B2-adrenoreceptor stimulant (salbutamol) inhaler via spacer
Struggling to breathe sit up
Repeat inhaler every 10 minutes
What is given in a suspected angina attack? and then MI?
GTN spray sublingual
300mg aspirin for MI - improves prognosis
What are the actions that need to be taken if an epileptic seizure were to occur in the dental chair?
How do the doses differ in children?
10mg midazolam in buccal sulcus or floor of nose
ABCDE
(<6months = 2.5mg max, 6months-1yr = 2.5mg, 1-5yrs = 5mg, 5-10yrs = 7.5mg)
What is the 1.conscious and 2.unconscious management of a hypoglycaemic attack?
- Oral glucose: glucogel/ 2-4tsp of sugar
1. IM/SC 1mg glucagon
What treatment is provided in an adrenal crisis?
Dentist: Put pt flat and legs up, clear airway, oxygen 15L/min
Paramedics: 200mg IV hydrocortisone, IV fluids
How is a MI treatment in a child carried out?
5 rescue breaths, 15 compressions, 2 ventilations
How is meningitis detected?
Roll tumbler and doesn’t fade
What are 1.shockable and 2.non shockable arrhythmia’s with an AED?
- VF, pulseless VT
2. Asystole, pulseless electrical activity
What is the normal amount of oxygen to give a patient in a medical emergency?
15L/min
What is impetigo and how is it treated?
Staphylococcus skin infection with gold encrusted highly infectious lesions
Fuscidic ointment or penicillin-based antibiotic if systemic
What are oral signs a patient has addisons disease?
Adrenal hypofunction
Pigmentation in buccal mucosa/ FOM
What is the treatment for oral lichen planus?
Low dose steroids
How is CN IX palsy tested for?
Patient says AHHH, uvula moves to RHS = LHS problem
What is the oral side effect of CCBs?
Gingival overgrowth
What is the steroid, brown inhaler called?
Beclomethasone
What homeostatic measures should be taken in a person with a bleeding disorder?
Local measures - sutures, oxidised cellulose
Anti-fibrinolytic agents - tranexamic acid
