Medical Emergencies in Dentistry

Question 1

What are the ABCDE assessment?

Answer 1

A - airway
B - breathing rate
C - circulation
D - disability
E - exposure

Question 2

What are the CAUSES, RECOGNITION, TREATMENT for an Airway assessment?

Answer 2

Causes - loss of consciousness

Recognition - talking, sounds, work

Treatment - head tilt & jaw thrust

Question 3

What are the CAUSES, RECOGNITION, TREATMENT for a Breathing assessment?

Answer 3

Causes - demand, infection, inflammation

Recognition - rate, look, listen, feel

Treatment - posture, oxygen, bronchodilators

Question 4

What are the CAUSES, RECOGNITION, TREATMENT for a Circulation assessment?

Answer 4

Causes - arrhythmia, acute coronary syndromes, heart failure

Recognition - pulse check

Treatment - treat cause/elevate legs

Question 5

What are the CAUSES, RECOGNITION, TREATMENT for a Disability assessment?

Answer 5

Causes - drugs/brain injury/hypoglycemia

Recognition: ACVPU, GCS

Treatment: Optimise ABC

Question 6

What are the CAUSES, RECOGNITION, TREATMENT for an Exposure assessment?

Answer 6

exposure to risk is limited in the dental setting, look for clinically relevant info then REASSESS!

Question 7

What are emergency conditions?

Answer 7

• Anaphylaxis
• Angina/MI
• Cardiac Arrest
• Choking
• Hypoglycemia
• Seizure/fits
• Syncope (passing out)

Question 8

when a patient requires oxygen, how much do you give them?

Answer 8

15 Litres with a non-rebreathing mask

GDC advice - give to anyone who is sick

Question 9

What is the ABCDE for anaphylaxis?

Answer 9

A - swelling, noisy breathing, tight

B - increased rate, wheeze

C - increased rate, hypotension

D - loss of consciousness

E - rash, swelling

Question 10

how do you treat someone with anaphylactic shock?

Answer 10

Adrenaline 1:1000, 0.5mg [EpiPen]

INTRAMUSCULAR INJECTION (usually into the thigh)

Question 11

What is the ABCDE for Angina/MI?

Answer 11

A - talking

B - increased

C - increased

D - alert

E - pale, central chest pain, a little sweaty due to increased body demands

Question 12

what is the emergency treatment for angina/mi?

Answer 12

GTN spray 400micrograms per dose [ANGINA]

Aspirin 300mg crushed/chewed [MI]

Question 13

What is the ABCDE for Asthma?

Answer 13

A - difficult to complete sentences

B - Increased rate with wheeze

C - Increased

D - alert

E - tripods (standing on 2 feet with hands on thighs as support)

Question 14

What is the emergency treatment for asthma?

Answer 14

Salbutamol inhaler 100 micrograms per actuation

Use a spacer when appropriate

Question 15

What is the emergency treatment for Cardiac arrest?

Answer 15

If unresponsive, not breathing and no heart rate

DRSABC

Call 999 ask for ambulance (MUST SAY CARDIAC ARREST)

Start CPR & Breaths, try get AED before ambulance if possible

Question 16

What is the emergency treatment for choking?

Answer 16

Assess severity

Severe;
Conscious: 5 back blows, then 5 abdominal thrusts
Unconscious: Start CPR

Mild;
Encourage could till dislodged

Question 17

What is the emergency treatment for choking?

Answer 17

Assess severity

Severe;
Conscious: 5 back blows, then 5 abdominal thrusts
Unconscious: Start CPR

Mild;
Encourage could till dislodged

Question 18

What is the ABCDE for Hypoglycemia?

Answer 18

A - Initially talking

B - initially increased rate

C - initially increased rate

D - Initially alert

E - irritable, confused, pale

Question 19

What is the emergency treatment for Hypoglycemia?

Answer 19

• Glucose
• Glucagon 1mg IM injection

Question 20

What is the ABCDE for Seizures/Fits?

Answer 20

A - compromised
B - ?
C - ?
D - Unresponsive
E - Seizure activity, incontinence

Question 21

What is the emergency treatment for seizures/fits?

Answer 21

• ensure pt is in a safe environment
• if repeated or prolonged, consider midazolam 10mg via buccal mucosa

Question 22

What is the ABCDE for Syncope (passing out)?

Answer 22

A - compromised
B - reduced
C - reduced rate and blood pressure
D - unresponsive
E - pale, mild sweating