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Oral Surgery > Medical Emergencies in the Dental Office > Flashcards

Medical Emergencies in the Dental Office Flashcards

1
Q

3 components of emergency drills

A

1-keep it simple
2- designate a specific task to each staff member
3-quarterly drills

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2
Q

ABCs of any emergancy

A
  • supine position
  • 100% oxygen
  • Airway, Breathing, Circulation
  • vitals
  • knowledge of AED
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3
Q

5 things to include in documenting of an ermergency

A 
1-history of event
2- positive primary and secondary survey
3- tx provided
4-time of events
5-disposition
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4
Q

what is the most common medical emergency in dentistry?

A

vasodepression synope

*30% of adults will have this at some point

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5
Q

what is the etiology of syncope?

A

decreased cerebral blood flow

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6
Q

what are some common causes of syncope?

A

needles, stress, fear, pain, etc

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7
Q

what is the differential for syncope?

A
  • anxiety
  • hyperventilation syndrome
  • MI
  • hypoglycemia
  • epilepsy
  • hypotension
  • neurocardiogenic syncope
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8
Q

early pre-syncope signs

A

nausea, warmth, sweating, loss of color, tachycardia

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9
Q

late pre-syncope signs

A

hypotension, bradycardia, pupil dilation, coldness, visual disturbances, loss of consciousness

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10
Q

what are the phases of syncope?

A

1-decreases CBF
2-loss of consciousness
3-loss of postural tone

*if you are out for longer than a couple minutes you can get seizures

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11
Q

risk of cardiovascular disease doubles for every increment of ____ mmHg of systolic or every ___ mm Hg of diastolic bp

A

20, 10

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12
Q

if over 50 ears old, a systolic BP of what is a more important risk factor than diastolic?

A

> 140

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13
Q

stage 1 hypertension

A

140-159/or90-99

*confirm BP, proceed with elective tx, recheck BP

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14
Q

stage 2 hypertension

A

> 160/or100

*emergency tx, see dr. before elective tx

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15
Q

2nd most common cause of loss of consciousness in dental office?

A

orthostatic hypotension

**standing systolic drops by 25, standing diastolic drops 10

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16
Q

why do the elderly get orthostatic hypotension?

A

decreased baroreflex mechanism. impairs cardiac response to preload

*meds can make worse, elderly are most susceptible

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17
Q

what two things should a diabetic patient be instructed to do prior to an appointment?

A

Eat and take their meds prior to coming in

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18
Q

what are some common ways patients will become hypoglycemic?

A

too much insulin, alcohol, too much exercise, missed meal

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19
Q

Autonomic symptoms of hypoglycemia

A

sweating, trembling, palpitations, anxiety, nausea

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20
Q

Neuroglycopenic symptoms

A 
dizziness
confusion
difficulty speaking
headache 
inability to concentrate
weakness
blurred vision
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21
Q

Tx for the hypoglycemic patient

A

give sugary food/water, seek med. attention, give glucose

**if tx is delayed, death or serious injury may result

22
Q

What are some cause of seizures?

A

brain tumor/injury, poison, electric shock, heat stroke, fever, etc.

23
Q

What are some symptoms of seizures?

A

muscle rigidity, short scream, drooling, etc

24
Q

If a patient is having a seizure, what are two things you should NOT do?

A

1- Do NOT put anything in patient’s mouth

2-Do NOT hold patient down

25
Q

What are 3 possible sequelae of aspiration in the dental office?

A

1-infection
2-pneumonia
3-lung abscess

26
Q

2 steps to remove a dropped object in the mouth

A

1-suction

2-use forceps (martin or magill)

27
Q

3 steps if object falls in px throat?

A

1-position dental chair with head below chest
2-turn px on their side
3-if object is retrieved, dismiss them without radiographs

28
Q

What are Some symptoms of anaphylactic shock?

A

Coughing, itching/hives, swelling, bluish skin, perioral edema, weakness, etc

29
Q

What are some Tx for anaphylactic shock featuring respiratory distress?

A

1-supine position, summon EMS, ABCs, O2,

2-EPI pen (IM or SC) or diphenhydramine (IV or IM)

30
Q

What are some Tx for anaphylactic shock featuring milder symptoms like itching?

A

1-diphenhydramine (IM or IV)

2-monitor px to make sure it does not progress to shock

31
Q

Local anesthetics are linked to what percent of dental office deaths?

A

50%

32
Q

what is the max dose of epinephrine for cardiac patients?

A

.04 mg

*this equates to 2 carps of LA with 1:100,000 epi

33
Q

Tx for LA overdose

A

position px comfortably, give O2, if bp is elevated with cerebrovascuar accident call EMS, if no cerebrovascular problems, send home.

34
Q

Do asthmatics have a more challenging time inhaling or exhaling?

A

exhaling

*remind px to bring inhaler

35
Q

what two things should you not give an asthmatic px?

A

1-Aspirin and other non-steroidal anti-inflammatory drugs

2-LA containing bisulfites (acts as a preservative)

36
Q

If a patient has an asthma attack, what should you do?

A

give them their inhaler (beta agonist), give O2 if needed, epinephrine SC or IM

37
Q

Tx for angina

A

sublingual nitroglycerin, O2, stop dental tx,

*if nitroglycerine is not effective, call EMS and give a second dose of nitro

38
Q

pathogenesis of an MI

A

mismatch in oxygen consumption and delivery

39
Q

besides the arm, where else might a px feel an MI

A

shoulder, neck, jaw, midback, stomach

40
Q

if you have conscious px have and MI, what do you do?

A

seat px, keep them calm, call 911, administer MONA

*morphine, oxygen, nitroglycerine, aspirin

41
Q

how long should a patient avoid elective dental treatments following and MI?

A

6 months

42
Q

T/F antibiotic prophylaxis might cause more harm than good

A

true

*allergies, bad reactions, etc

43
Q

what are 4 indications for antibiotic prophylaxis?

A

1-artificial heart valves
2-history of previous infective endocarditis
3-congenital heart conditions
4-cardiac transplat ONLY if valvulopathy occurs

44
Q

is it necessary to give antibiotics to a px who has a prosthetic joint?

A

No

*but it is common practice to give it up to 2 years after its placement

45
Q

basic emergency drug for asthma/allergy

A

epinephrine

46
Q

basic emergency drug for mild allergic reaction?

A

Benadryl

47
Q

basic emergency drug for angina

A

nitroglycerine

48
Q

basic emergency drug for bronchospasm

A

albuterol

49
Q

basic emergency drug for hypoglycemia

A

glucose

50
Q

basic emergency drug for MI

A

aspirin

51
Q

basic emergency drug for syncope

A

ammonia

52
Q

basic emergency drug for most things

A

oxygen

Oral Surgery (6 decks)

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