Medical Emergencies in Dentistry Flashcards
What are the steps followed when assessing a patient with a suspected medical emergency?
A - airway
B - breathing
C - circulation
D - disability
E - exposure
What are some potential causes of airway obstruction?
- choking
- infection
- inflammation
- swelling
- anaphylaxis
How can you recognise that a patient has an obstructed airway?
are they able to
- talk
- make sounds
- conscious
How can an obstructed airway be treated?
- triple manoeuvre = head tilt, jaw thrust, chin lift
- adjuncts = oropharyngeal airways
What can alter a patient breathing pattern?
- increase/decrease in demand
- infection
- inflammation
- muscular problem
how can we assess a patients breathing ability?
- look at them (rise & fall of chest/shoulders)
- listen to any sounds made
- look at their skin
At what oxygen saturation level (roughly) do the fingers and lips turn blue?
84%
At what oxygen saturation level does the tongue turn blue?
60%
What are some causes of an abnormal heartbeat rhythm?
- arrhythmias
- excessive exercise
- ACS
how can we determine a patients circulation health?
Check their pulse
- heart rate
- blood pressure
- cardiac output
- heart rhythm
If a patient has low blood pressure what can be done?
lie down and elevate legs
What are examples of emergency medical conditions you may see in the dental practise while treating patients?
- anaphylaxis
- angina/MI
- asthma
- cardiac arrest
- choking
- hypoglycaemia
- seizure/fits
- syncope
How would a patient suffering from anaphylaxis present on examination?
A = swelling/stridor
B = increased rate, wheeze
C = increased rate, hypotension
D = loss of consciousness
E = rash, swelling
How is anaphylaxis treated?
- give oxygen 15L/min
- adrenaline IM 1:1000, 0.5mg
- use Z track technique
How would a patient suffering from angina/MI present on examination?
A = talking
B = increased rate
C = increased rate
D = alert
E = pale, clammy, central chest pain
How would a patient with angina (on exertion) be treated?
- rest first to see if it stabilises
- if not give GTN spray, 2 sprays sublingually
- if still in pain give 300mg aspirin chewed
If you suspect a patient is suffering from MI, what would your course of treatment be?
- get patient into comfortable position
- administer oxygen 15L/min
- GTN spray sublingual x2
- 300mg aspirin chewed or crushed (delay drink of water for 10 mins)
If a patient is suffering from a mild/moderate asthma attack, what is your course of treatment?
- 2 puffs of salbutamol inhaler (no spacer) and hold for 10 seconds
If a patient is suffering from a severe/acute asthma attack, what is your course of treatment?
- use spacer device with 10 puffs of salbutamol and let patient breathe for 20 secs
- then move onto 15L/min oxygen
How would a patient suffering from hypoglycaemia present?
A = initially talking, may lose consciousness
B = initially increased rate
C = initially increased rate
D = Initially alert
E = irritable, confused, pale
What is the treatment for a hypoglycaemic patient that can talk?
Give glucose (rapid relief gel swallowed/rubbed into gums) and monitor
What is the treatment for a hypoglycaemic patient that has lost consciousness?
Glucagon 1mg IM injection
- comes as a separate fluid & powder, infect fluid into powder, invert until mixed DO NOT SHAKE!
- use Z track technique
- after they regain consciousness try to give them some glucose
What are the side effects of IM glucagon injection?
Severe nausea
How would a patient suffering from a seizure/fit present?
A = compromised
B = differs in each patient
C = differs in each patient
D = unresponsive
E = seizure activity, incontinence
How would you treat a patient that is suffering from a seizure?
- oxygen 15L/min
- time the seizure(s)
- if prolonged seizure (>5 mins) or multiple seizures give 10mg Midazolam via buccal mucosa (squirt into buccal sulcus)
How would a syncope patient present on examination?
A = compromised
B = reduced rate
C = reduced rate & pressure
D = unresponsive
E = pale and clammy
reverts back to normal very quickly (if not suspect something else)
What is the treatment option for syncope?
Elevate legs
