TOK medical emergencies Flashcards
Which of the following statements are true? Select those
that apply: Team leading the helpers during a medical
emergency in the dental practice
Requires team members communicating important observations (eg faulty equipment) to the leader Includes taking into account the abilities and physical limitations of team members
Which statements are true? A dental patient
Taking regular ACE inhibitors may be at higher risk of collapse after suddenly getting up from their dental chair With a history of recurrent syncope should be given oxygen if they show the following signs: light headedness, sweating, slow pulse rate
Who can administer injectable drugs for the purpose of
saving a life in an emergency?
Anyone
Which statement is true? In the event of a dental patient being very unwell and requiring transfer to hospital
Ambulance personnel are not responsible for contacting next of kin
Which of the following are considered drugs for
emergency use?
Adrenaline Oral glucose Midazolam buccal liquid Aspirin
NDAC recommend that the following emergency drugs are
available at all times (tick all that apply)
Oral glucose/ sugar GTN spray (400 microgram metered dose) Midazolam buccal liquid (10mg/mL), or Midazolam injection (as hydrochloride) (5mg/mL 2mL ampoules) for topical buccal administration
What equipment do the Resuscitation Council (UK)
recommend is available for dealing with medical
emergencies in a dental practice?
Defibrillator Spacer device for inhaled bronchodilators Portable oxygen cylinder
When carrying out a “moderate risk” procedure for a
patient in a nursing home, SDCEP Practice Support Manual
specifically recommends that which of the following
should be available?
A bag-valve mask Spacer devices for inhaled bronchodilators Portable independently powered suction
What is the recommended minimum length of time that
an urban practice should be able to provide oxygen at 15
litres per minute for a patient?
30 minutes
SDCEP advice on emergency life support training specifies
which of the following key topics should be covered?
How to use emergency equipment correctly including ‘glucose assessment’ How to use emergency medication including drawing up a syringe How to assess the acutely ill patient
Which statement is false? The ‘ABCDE’ system of assessing
and treating a sick patient
Needs to be fully completed before calling an ambulance
Which of the following statement are true? Select those
that apply: Regarding medical emergency patients
requiring transfer to hospital:
The dental practice is responsible for contacting next of kin The dental practice is responsible for identifying suitable routes for transferring patient off the premises
which statement is false? A patient undergoes a dental
procedure during which local anaesthetic is used. Shortly
afterwards he complains of difficulty in breathing with an
audible wheeze, a swollen tongue. He is sweaty, the pulse
rate is 110’ (regular), capillary refill time is 4 seconds.
Salbutamol is the first-line drug in this situation.
False (Adrenaline 0.25mg i.m. should be given if the patient is > 12 years old)
Which statement is false?
A patient undergoes a dental procedure during which local anaesthetic is used. Shortly afterwards he complains of difficulty in breathing with an audible wheeze, a swollen tongue. He is sweaty, the pulse rate is 110’ (regular), capillary refill time is 4 seconds.
Elevating the legs of the patient may be appropriate
Following a reaction to the administration of local
anaesthetic, anaphylaxis can be excluded if there is no
visible rash
False
A patient undergoes a dental procedure during which local
anaesthetic is used. Shortly afterwards he complains of
difficulty in breathing with an audible wheeze and a
swollen tongue. He is sweaty, the pulse rate is 110’
(regular), capillary refill time is 4 seconds. Chlorphenamine
is the first-line drug in this situation.
False
A patient undergoes a dental procedure during which local
anaesthetic is used. Shortly afterwards he complains of
difficulty in breathing with an audible wheeze and a
swollen tongue. He is sweaty, the pulse rate is 110’
(regular), capillary refill time is 4 seconds.
Salbutamol is the first-line drug in this situation
Flase
Which statements are true? Select those that apply: A
patient undergoes a dental procedure during which local
anaesthetic is used. Shortly afterwards he complains of
difficulty in breathing with an audible wheeze and a
swollen tongue. He is sweaty, the pulse rate is 110’
(regular), capillary refill time is 4 seconds.
The A-E approach should be followed Cardiac arrest may occur and the dental team should prepare for this
Which statement is true? Adults with an asthma attack
May benefit from salbutamol, given through a spacer device.
Cardiac compressions during CPR in an adult, should be
interrupted every 4 minutes to check for signs of life.
False
Which of the following is/are true in relation to the
placement of defibrillator pads:
Scissors may have to be used to remove the patient’s clothing.
Regarding the type of oropharyngeal airway device
(Guedel airway) shown in the image
The correct size should be selected by judging the distance from the angle of the jaw to the tip of the front teeth If used inappropriately, it could worsen airway obstruction
Which statement is true? A dental patient with no known
history of cardiovascular medical history suddenly
complains of chest pain.
Aspirin 300mg orally, crushed or chewed may be indicated.
Which statement is true? A dental patient with no
cardiovascular medical history suddenly complains of
chest pain.
The A-E approach should be used to assess the patient
A dental patient with no cardiovascular medical history
suddenly complains of chest pain. Anxiety of the patient
can have adverse physiological effects. True or False?
True
Which of the following statements is true regarding
automated external defibrillation during cardiac arrest?
Current guidelines recommend ECG analysis every 2 min
Which statement is true? Automated defibrillation during CPR in an adult.
Has a proven benefit on patient survival.
Which statement is true? During a cardiac arrest in a
dental practice
Oxygen should be attached to the ventilation device if possible
Automated external defibrillation requires placing one
electrode 1cm below the left clavicle and one electrode on
the right side of the chest of the patient
False
Which statement is false? In the situation where there is a
known cardiac arrest:
The compression to ventilation ratio in an adult is 15:2
Which statements are true? Select those that apply: A
dental patient with no cardiovascular medical history
suddenly complains of chest pain.
The patient may be at risk of a sudden cardiac arrest The capillary refill time may be normal in this patient If the patient is treated with Aspirin, it is appropriate to call for an ambulance
Which of the following statements are true? Select those
that apply: During a cardiac arrest in a dental practice
Part of a team leader’s role is to ensure the safety of other patients CPR may need to be interrupted and the patient moved if the area is not safe
Which of the following statements are true? Select those
that apply: If a cardiac arrest occurs in an infant (<1 year
old)
The airway should be opened by tilting the head back as much as possible? It is most commonly due to respiratory problems The child may be carried by a lone helper in order to get help Chest compressions should be given with 2 fingers or thumbs only An adult pocket mask can be used for ventilation where no paediatric version is available
If an adult collapses and no helpers are available, starting
CPR immediately is more important than calling 999
False
Which of the following statements are true regarding CPR
in children by healthcare professionals? Select those that
apply:
After rescue breaths have been given the recommended ratio of compression and ventilation is the same in adults and children Impaired breathing is a more common reason for cardiac arrest in infants than a shockable rhythm is
Which of the following statements are true regarding CPR
in children by healthcare professionals?
A two-handed technique may be appropriate in older children The rate of compression(100-120/ min) is the same in adults and children
Which statement is true? During CPR in an adult
Spontaneous eye-opening or active limb movement in the patient are definite signs of life
Which of the following statements are true? Select those
that apply: The Chain of Survival
Is only as strong as its weakest link Comprises post resuscitation care to restore quality of life
Includes early recognition of unwell patients and early defibrillation
Which of the following statements regarding an AED
(automated external defibrillator) are true? Select those
that apply:
In modern (biphasic) AEDs, left and right electrodes are usually interchangeable Studies have shown that early defibrillation improves survival in cardiac arrest
If no purpose-made paediatric pads are available for an
AED, an unmodified adult AED may be used in children
from 1-8 years
True
Which of the following statements is false regarding an
Automated External Defibrillator (AED)?
AED pads usually expires after 5-8 years
Which statements are true? Select those that apply:
During a cardiac arrest situation
Applying an external defibrillator takes priority over ventilation attempts Effective cardiac compressions are proven to improve chances of survival
If a patient requiring defibrillation is lying on a wet surface
Defibrillation is safe so long as the rescuer is not in contact with the patient
For a patient who has suffered a shock-able arrest, five
minutes delay before defibrillation reduces the chances of
survival:
By approximately 50%
Automated external defibrillation use in dental practice
should be administered, if possible, by trained staff and
usually requires removal of patient’s clothing
True
How should you manage a patient with epilepsy who is
having a seizure?
Administer midazolam if fit is repeated or lasts more than 5 minutes. Ensure the patient is not at risk of injury. Administer oxygen if appropriate.
SDCEP guidance recommends calling an ambulance for a
patient who has had an epileptic seizure in which of the
following circumstances (select all that apply)
If this was the first episode of epilepsy for the patient The seizure lasts for 5 minutes or longer
True or false? If an epileptic seizure occurs, where
possible, the patient should be given oxygen at flow rate
of 15 litres/minute
True
A dental patient has a generalised, tonic-clonic seizure.
Cyanosis may be seen, even if the patient has no
underlying respiratory disease.
True
According to SDCEP guidance, which of the following are
indications for giving midazolam in the event of an
epileptic seizure (select all that apply)
The convulsive seizures last longer than 5 minutes The seizures recur in quick succession
Which statement is true? A dental patient has a generalised, tonic-clonic seizure.
Convulsive movement should not be restrained
Which statements are true? Select those that apply: A
dental patient has a generalised, tonic-clonic seizure.
Hypoxia is a common feature during seizures Glucose may be an appropriate treatment once the patient has woken up Medication should only be given if seizures last for 5 minutes or longer or recur in quick succession
Which of the following are true in relation to midazolam
(select all that apply):
It is the only controlled drug which are justified to stock It is a schedule 3 controlled drug Dentists must have standard operating procedures and adequate controls in place to cover all aspects of the use of midazolam
A dental patient has a generalised, tonic-clonic seizure.
Convulsive movements should not be restrained and it
may not be required to transfer the patient to a hospital
once they have recovered.
True
Which statement is false? Loss of consciousness
And gasping, irregular breathing, should be primarily managed by placing the patient in the recovery position.
Which statement is true? In a collapsed adult patient who
is unresponsive
And breathing normally, the recovery position may be indicated.
If an adult patient collapses in the dental practice, you
should check for responsiveness before opening the
airway.
True
If an adult patient collapses in the dental practice, the
correct sequence of actions is to check for breathing, then
call 999 and then check for danger.
False
If an adult patient collapses in the dental practice, head-tilt
and chin-lift should be used to open the airway and may
relieve airway obstruction
True
Which statements are true regarding the situation below?
Select those that apply: A patient is about to have a dental
procedure. When getting up from the chair in the waiting
room they collapse.
Elevating the legs of the patient may be appropriate. It may be appropriate not to call an ambulance if the collapse is brief (less than 1 minute) and the patient fully recovers. The collapse may have been caused by sudden drop in cerebral perfusion
Which statements are true? Select those that apply: A
dental patient
With a history of recurrent syncope should be given oxygen if they show the following signs: light headedness, sweating, slow pulse rate. Taking regular angiotension converting enzyme (ACE) inhibitors may be at higher risk of collapse after suddenly getting up from the dental chair.
Which of the following statements are true? Select those
that apply: The recovery position should be used
For no more than 30 minutes before turning the patient onto the opposite side. To prevent airway obstruction in unconscious, breathing patients.
The ‘’key signs’’ of hypoglycaemia include (select all that
apply).
Aggression, Confusion, Sweating
Which of the following are common signs in a patient suffering from hypoglycaemia?
Aggression, Confusion, Sweating, Tachycardia
If a patient regains consciousness following administration
of glucagon, they should also be given 10-20 grams of oral
glucose. True or False?
True
If a patient is hypoglycaemic and becomes unconscious or
uncooperative, which of the following are indicated.
IM Glucagon
Which statement is true? The pocket face-mask, such as
shown in the image:
Incorporates a one-way valve and can be effectively used in infants Can be used to ventilate patients who are not breathing Should be removed before defibrillation?
Which of the following statements are true? Select those
that apply Breathing problems caused by vomitus in the
airway (aspiration)
May result in an abnormal breathing pattern May result in stridor May require salbutamol as treatment May be resolved by asking the patient to cough vigorously
Which of the following statements are true? Select those
that apply: If choking occurs in a child
Who then becomes unconscious, initially 5 attempts of 5 ventilations should be made Which is severe, initially 5 back blows should be given It might be appropriate to encourage coughing without further physical maneuver
Which statement is false? A choking child
Attempts should be made to blindly remove a foreign body from the airway (blind finger sweep) Of less than 1 year (infant), abdominal thrust should be given if initial back blows are not successful
Which of the following statements is false regarding the
situation in the picture above?
If the child has stopped breathing after choking, ventilation must be avoided
Which of the following statements are true regarding the
situation shown in the above picture showing an
unconscious infant patient? Select those that apply:
The manoeuvre shown is appropriate provide cardiac compressions during an asystolic heart rhythm Chest thrust may be appropriate to treat choking
Oxygen therapy in a critically ill patient
Should commence at high flows (15L/min) Should be provided by an oxygen face mask with a reservoir if the patient is breathing adequately
Which statement is true? The oxygen mask shown in the
image:-
Should be removed before defibrillation
Which of the following statements are true? Select those
that apply: Regarding the type of oropharyngeal airway
device (Guedal airway) shown in the image
The correct size should be selected by judging the distance from the angle of the jaw to tip of the front the front teeth If used inappropriately, it could worsen airway obstruction
Which statement is true? The type of suction device
shown in the image
Can be used when mains electricity fails or the patient is remote to the dental chair aspirator Needs to be stored disassembled to maintain sterility of the components Is not required in a dental practice if the dental chair has a built-in aspirator
Which of the following statements are true? Select those
that apply. Regarding the mask device shown above
It will deliver atmospheric (21%) oxygen concentration if no supplementary oxygen is attached to the device An oropharyngeal airway inserted into the patient may improve ventilation with the device during a cardiac arrest Its use could lead to aspiration of stomach contents
Which of the following statements are true? Regarding the
bag-valve mask device shown above
It can be used in a patient who becomes unresponsive during severe choking It can be used in a patient who has signs of circulation but is not breathing adequately, to give 10 to 12 breaths per minute
