Office Emergencies (Deluke)

Question 1

When considering emergencies in the dental office what should the focus be on?

Answer 1

1. Prevention

2. Preparedness

Question 2

What is a major way to avoid the pandemonium common in an office emergency?

Answer 2

Run mock drills and keep records of them

Question 3

What is a preventive measure with each patient to decrease the likelihood of an emergency?

Answer 3

Take and review medical history prior to each procedure

Question 4

If the patient takes nitroglycerin, and begins to have chest pains, when should the decision be made to transport the patient?

Answer 4

1. Complaint changes from just chest pain
2. Chest pain is not relieved with nitroglycerin (up to 3)
3. Deteriorating vital signs

Question 5

What are 2 preventive measure to avoid emergency in a patient with chest pains prior to dental treatment?

Answer 5

1. Have the patient take prophylactic nitroglycerin

2. Put patient on O2 for procedure

Question 6

What is a common device used for the prevention of foreign body aspiration?

Answer 6

Throat screen

Question 7

What should you be prepared to do in a possible aspiration?

Answer 7

1. Heimlech maneuver

2. Cricothyroidotomy

Question 8

If a patient has pallor, perspiration, beads on the palate, a slow and weak pulse, and a low BP, what are they getting ready to do?

Answer 8

Faint / syncope

Question 9

What would heighten a syncope episode to where you are thinking it is not just syncope?

Answer 9

1. Patient does not recover quickly

2. Patient has an underlying history (e.g. MI)

Question 10

What are 7 differential diagnoses for a patient in an altered state of consciousness?

Answer 10

1. Vasovagal reaction
2. Stroke
3. Acute cardiovascular event
4. Self-administered drug overdose
5. Hypo or hyper glycemia
6. Uncontrolled hypothyroidism
7. Anaphylactic shock

Question 11

If you happen upon someone unconscious, what are your first steps?

Answer 11

1. Basic first aide
2. Defibrillate
3. Compressions
4. Airway
5. Breathing

Question 12

If there is no pulse on the patient, what do you do?

Answer 12

Chest compressions

Question 13

What are 2 main drugs for managements of allergic reactions?

Answer 13

1. Epinephrine 0.5-1mg

2. Benedryl 25-50 mg

Question 14

Are steroids primary management for allergic reaction?

Answer 14

No. Secondary.

Question 15

A diabetic patient with nausea, diaphoresis, and tachycardia would be in what state: hypoglycemia or hyperglycemia?

Answer 15

Hypoglycemia

Question 16

A diabetic patient that might have previous symptoms as well as fruity breath from ketones would be in what state: hypoglycemia or hyperglycemia?

Answer 16

Hyperglycemia

Question 17

What is the difference with the symptoms and outcomes of diabetic hypoglycemia versus hyperglycemia?

Answer 17

The patient usually recognizes hypoglycemia symptoms but may not recognize their hyperglycemia symptoms which can put them on the way to a diabetic coma.

Question 18

What are questions to ask to help avoid a seizure in a patient with a history of seizures?

Answer 18

1. Last seizure

2. Medication

Question 19

A patient is having sudden weakness in the face and arm, especially unilaterally, or the sudden onset of confusion, and trouble speaking. They could have a disturbance in their gait, a severe headache with no apparent cause, or visual changes. They may be experiencing what?

Answer 19

A atroke

Question 20

What is critical for responding to a stroke?

Answer 20

1. Activate EMS
2. Support with oxygen
3. Early intervention is key

Question 21

What should a labile asthmatic do prior to dental treatment?

Answer 21

Take a hit off their inhaler

Question 22

Every GP emergency kit should have what inhaler type?

Answer 22

Albuterol

Question 23

What are the disadvantages of the prepackaged emergency kit?

Answer 23

Not made by the office, so not as familiar with content

Question 24

What is indicated if the office is doing sedation?

Answer 24

Require a more comprehensive emergency kit

Question 25

What are 9 critical items for an office drug kit?

Answer 25

1. Cardiac defibrillator
2. Epinephrine
3. Needles / syringes for delivery of parenteral meds
4. Benedryl tablets and parenteral
5. Nitroglycerin for sublingual administration
6. Aspirin (ASA)
7. Concentrated glucose product
8. Alubterol inhaler
9. Oxygen delivery system with suitable mask (adult and peso) and ability to generate positive pressure)