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Patient Care > Medical Emergencies in the Dental Office > Flashcards

Medical Emergencies in the Dental Office Flashcards

1
Q

it is estimated that each dentist will experience - to - life threatening emergencies during his or her professional career

A

1-2

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2
Q

preparation

A

FEMA’s: motivates people and communities to take action to prepare for and protect themselves against disasters

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3
Q

category 1: minor

A

simple fate

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4
Q

trendelenburg position

A

the body is laid supine or flat with a 15-30 degree incline with the feet elevated above the head

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5
Q

category 2: intermediate

A

O2 + repositioning

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6
Q

category 3: major

A

referral to MD or hopsital (ER)

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7
Q

ideal blood pressure

A

120/80

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8
Q

ideal heart rate and rhythm

A

60-110

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9
Q

ideal respiratory rate

A

16-18

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10
Q

determination of medical risks (5)

A 
medical history questionnaire 
physical evaluation 
dialogue history 
medical consultation (if necessary)
ASA classification
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11
Q

what we might see in the dental office (8)

A

bleeding that will not stop
breathing problems (difficulty breathing, shortness of breath)
change in mental status (unusual behavior, confusion)
chest pain
choking
coughing up or vomiting blood
fainting or loss of conciousness

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12
Q

ASA 1

A

healthy patient, no systemic disease

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13
Q

ASA 2

A

mild systemic disease

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14
Q

ASA 3

A

severe systemic disease

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15
Q

ASAA 4

A

incapacitating systemic disease that is a constant threat to life

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16
Q

ASA 5

A

moribund patient not expected to survive 24 hours without an operation

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17
Q

ASA 6

A

brain dead, organ harvest for donation

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18
Q

ASA E

A

emergency operation

added to patients physical status classification

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19
Q

levels of consciousness (4)

A

awake
altered
unconscious
seizures

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20
Q

altered

A

pre-syncope, TIA (ischemic attack, mini stroke)

21
Q

unconscious

A

syncope, orthostatic hypotension

22
Q

seizures

A

hyperventilation, syncope, epilepsy

23
Q

airway- breathing (4)

A

obstruction
hyperventilation
asthma
COPD, emphysema

24
Q

cardiovascular (5)

A 
angina 
hypo/hypertension
dysrhythmia 
myocardial infarction
cardiac arrest
25
Q

angina

A

chest pain

26
Q

dysrhythmia

A

bradycardia, tachycardia

27
Q

drug related overdoes (overdose)

A

local anesthetics

sedatives

28
Q

reaction to drugs

A

allergy (rash, itching, airway)

29
Q

goals of physical evaluation (6)

A

ability to psychologically tolerate stress
ability to physically tolerate treatment
is treatment modification indicated
is psychosedation indicated
which sedation technique is indicated
any contraindications to premedications used

30
Q

recognition of anxiety (6)

A 
increased BP and pulse 
trembling
diaphoresis
restlessness
hyperventilation
dilated pupils
31
Q

stress reductional protocol (8)

A 
oral sedation  (pm and am)
intraoperative sedation
effective pain control - local anesthesia 
AM appointment 
time factor - short appointments 
hot and humid weather 
post-op RX prn
post-op phone call
32
Q

treatment modifications (6)

A 
intra-op oxygen
sedation - oral, N2O, IV
patient position
antibiotic premedication
cardiac pacemaker or defibrillator 
anticoagulant
33
Q

syncope

A

a transient loss of consciousness due to hypo perfusion of the brain and is characterized by a rapid onset and spontaneous resolution

a transient vascular and neurogenic reaction marked by pallor, nausea, sweating, bradycardia, and rapid fall in BP, which when below a critical Lebel, results in loss of consciousness due to generalized cerebral ischemia
usually evoke by emotional stress associated with fear or pain

34
Q

orthostatic hypotension

A

a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within 3 minutes of standing when compared with baseline BP

35
Q

orthostatic hypotension increases with

A

age

36
Q

syncope (pathophysiology) (7)

A 
stimulation of sympathetic system
fear or anxiety 
greater than 20% bone loss
rapid head up position
decreased cerebral flow 
reflex bradycardia 
complete recovery takes 24 hours
37
Q

syncope (psychogenic factors) (6)

A 
fright or anxiety 
pain
emotional stress
sight of blood
sight of dental instruments 
unwelcome news
38
Q

causes of syncope (5)

A 
upright or stand positions for extended periods of time 
hunger 
exhaustion 
poor physical condition
hot humid crowded environment
39
Q

vasovagal syncope (3)

A

sudden, rapid drop in HR and BP which leads to fainting
most common cause of syncope (about 32%)
most patients experience their first episode as a teenage or adolescent

40
Q

syncope manifestations (7) (symptoms)

A 
warmth
loss of color 
sweating 
feels bad 
nausea
BP at baseline
tachycardia
41
Q

late syncope manifestations (7)

A 
yawning 
difficult breathing 
pupillary dilation
cold hands and feet 
dizziness 
loss of consciousness 
hypotension and bradycardia
42
Q

syncope treatment (8)

A 
position patient horizontally 
airway and breathing 
circulation- vital signs 
oxygen
cool compress 
aromatic spirits of ammonia 
loosen clothing 
reassurance
43
Q

prevention of hyperventilation (4)

A

medical history
physical exam
recognize signs of anxiety
stress reduction protocol

44
Q

hyperventilation

A

to breathe at an abnormally rapid rate, so increasing the rate of loss of carbon dioxide

45
Q

in hyperventilation, rate of removal of CO2 from the blood is

A

increased

46
Q

as the partial pressure of CO2 in the blood decreases,

A

respiratory alkalosis ensues

47
Q

symptoms of hyperventilation (4)

A

tightness is chest - suffocation
rapid respiration - rapid pulse
light headless - apprehension
lump in throat - precordial pain

48
Q

signs and symptoms of hyperventilation (5)

A 
rapid and shallow breathing 
confusion 
dizziness
cold hands 
carpal-deal spasms; can lead to seizures
49
Q

hyperventilation management (7)

A 
terminate procedure 
position comfortably - usually upright 
rassure patient 
no oxygen
breathe into paper bag or headrest cover 
count to ten between breaths 
valium 5 mg IM or IV for severe cases

Patient Care (15 decks)

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