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CHHD > Medical Emergencies in Dentistry > Flashcards

Medical Emergencies in Dentistry Flashcards

1
Q

What should you pay attention to when observing the general physical condition of the patient

A
  • Patient’s Posture
  • Body movements
  • Quality of speech
  • Feel of the patient’s skin
  • Colour of the patient’s skin
  • Odours on the breath
  • Rate and pattern of respiration
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2
Q

What basic ME skills should the dental team be trained to do (minimum requirements)

A
  • BLS (basic life support)
  • CPR
  • Use of AED
  • Use of self inflating bag and mask devices
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3
Q

What should be available to the dental team as part of preparation for MEs

A
  • Easy and quick access to emergency drugs and equipment
  • Plan to summon medical assistance
  • Where possible drugs in solution should be in a pre-filled syringe
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4
Q

Give examples of how Medical Emergencies are classed systemically

A
  • Cardiovascular emergencies
  • Respiratory emergencies
  • Neurological emergencies
  • Metabolic emergencies
  • Miscellaneous
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5
Q

Give examples of cardiovascular emergencies

A
  • Myocardial Infarction
  • Angina
  • Cardiac Arrest
  • Syncope (fainting)
  • Postural Hypotension
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6
Q

Give examples of Respiratory emergencies

A
  • Hyperventilation
  • Respiratory Arrest
  • Acute Respiratory Obstruction: Inhaled foreign body
  • Asthma
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7
Q

Give examples of Neurological emergencies that you may encounter in the GD practice

A
  • CVA (stroke)
  • Status epilepticus
  • Loss of consciousness
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8
Q

Give examples of metabolic emergencies you may encounter in the GD practice

A
  • Hypoglycaemia
  • Hyperglycaemia
  • Addisonian crisis
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9
Q

Give some examples of the drug related (miscellaneous) emergencies

A
  • Anaphylaxis
  • Drug overdose
  • Drug allergy
  • Drug interactions
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10
Q

Describe the dose, route and mechanism of the drug you use for an Angina ME

A

Glyceryl Trinitrate Spray
Dose: 400 microgram/activation
Route: Sublingual
Mechanism: Potent vasodilator

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11
Q

Describe the dose, route and mechanism of the drug you use for an Asthma ME

A

Salbutamol Aerosol Inhaler
Dose: 100 microgram/activation
Route: Inhalation
Mechanism: B2 agonist

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12
Q

Describe the dose, route and mechanism of the drug you use for an Anaphylaxis ME

A

Adrenaline (1mg/ml)
Dose: 0.5 mg
Route: Intramuscular
Mechanism: Alpha receptor agonist, B1 agonist, B2 agonist, Mast cells stabilisation, Glucose elevation

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13
Q

Describe the dose, route and mechanism of the drug you use for a myocardial infarction ME

A

Aspirin Dispersable
Dose: 300mg
Route: Oral
Mechanism: Antiplatelet

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14
Q

Describe the dose, route and mechanism of the drug you use for an Unconscious hypoglycaemia ME

A

Glucagon
Dose: 1mg
Route: Intramuscular
Mechanism: Glycogenolysis

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15
Q

Describe the dose, route and mechanism of the drug you use for a conscious hypoglycaemia ME

A

Glucose solution/tablet/gel/powder
Dose: -
Route: Oral
Mechanism: -

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16
Q

Describe the dose, route and mechanism of the drug you use for an epilepsy (status epilepticus) ME

A

Midazolam
Dose: 10mg/ml
Route: Buccal
Mechanism: Muscle relaxant

17
Q

Describe the dose, route and mechanism of the drug you use for a syncope, MI, Stroke, anaphylaxis, epilepsy and adrenal insufficiency MEs

A

Oxygen
Dose: 15L/min
Route: Inhalation

18
Q

Name some medical emergency equipment that needs to be available in a GD practice

A
  • Portable oxygen cylinder
  • Oxygen face mask with reservoir and tubing
  • Pocket mask with oxygen port
  • Basic set of oropharyngeal airways
  • Self inflating bag and mask apparatus
  • Adult and child face masks for use with self-inflating bag
  • Portable suction e.g. yankauer sucker
  • Single use sterile syringes, needles and protective equipment (gloves, aprons, eye protection)
  • Spacer device for inhaled bronchodilators
  • Automated blood glucose measurement device
  • Automated external defibrillator (AED)
19
Q

What does ABCDE stand for when trying to assess and treat a patient in an ME

A 
Airway
Breathing
Circulation
Disability
Exposure
20
Q

Name a few of the general principles of managing MEs

A
  • Treat life-threatening problems as they are identified before moving to the next part of the assessment
  • Assess the effects of any treatment given (can take a few mins to work)
  • Continually re-assess starting with airway if there is further deterioration
21
Q

Name a few of the signs for airway obstruction

A
  • Paradoxial chest and abdominal movements
  • Use of accessory muscles of respiration
  • Central cyanosis in late stage
  • In partial obstruction - stridor, wheeze, gurgling or snoring may be noticed
  • In complete obstruction - no breath sound possible
22
Q

What needs to be done in the case of airway obstruction

A
  • Only simple methods of airway clearance needed in most cases
  • Open airway - head tilt/chin lift or jaw trust
  • Can use oropharyngeal airway adjuncts
  • In some cases give O2 at 15L/min flow rate
23
Q

What are the most common breathing problems in the GD practice

A

Hyperventilation and panic attacks - both tend to resolve with simple reassurance

24
Q

How do you measure/observe the circulation of the patient

A
  • Check the colour of the hands and fingers
  • Assess limb temperature by the patient’s hand - cool of warm?
  • Measure the capillary refill time
  • Count the patient’s pulse rate
  • Weak pulses + decreased conscious level + slow capillary refill time suggests low BP
25
Q

What simple measures can be taken to control/fix circulation issues in patients in the GD practice

A
  • Laying patient down and raising their legs

- If no response to simple measure, call ambulance

26
Q

What are the most likely causes of circulation problems in the GD practice

A

Simple faint/ vaso-vagal episodes

27
Q

What should be examined to measure any disability of the patient with an ME

A
  • Review and treat the ABCs: exclude hypoxia and Low BP
  • Check the patient’s drug record for reversible drug induced causes of depressed consciousness
  • Examine pupils: size, equality, reaction to light
  • Rapid initial assessment of patient’s consciousness level using AVPU method
  • Measure blood glucose to exclude hypoglycaemia, using a glucose meter
  • Nurse unconscious patients in the recovery position if their airway is not protected
28
Q

What procedures might need to be done in the exposure stage of ABCDE and what purpose do they serve

A
  • Loosen/remove some of patient’s clothes may be need to assess and treat properly - can see any rashes or perform procedures
  • Importnat to respect patient’s dignity and minimise heat loss when doing this

CHHD (27 decks)

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