Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endodontics 2 > TRIAGE & EMERGENCY SERVICES > Flashcards

TRIAGE & EMERGENCY SERVICES Flashcards

1
Q
  • Triage is the process of
A

sorting injured people based on their need for immediate
medical treatment as compared to their chance of benefiting from such care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  • Triage is done in (3)
A

emergency rooms, disasters, and wars, when limited medical
resources must be allocated to maximize the number of survivors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

White tags -

A

(dismiss) are given to
those with minor injuries for whom a
doctor’s care is not required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Green tags -

A

(wait) are reserved for
the “walking wounded” who will
need medical care at some point,
after more critical injuries have
been treated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Yellow tags -

A

(observation) for
those who require observation (and
possible later re-triage). Their condition is
stable for the moment and, they are not in
immediate danger of death. These victims
will still need hospital care and would be
treated immediately under normal
circumstances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Red tags -

A

(immediate) are used to label
those who cannot survive without
immediate treatment but who have a
chance of survival.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Black tags -

A

(Expectant) are used for the
deceased and for those whose injuries are so
extensive that they will not be able to survive
given the care that is available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dentists in the military or disaster control are often used to — thus freeing the medics to work critical care.
ANY 1st RESPONDER NEEDS AND MUST USE THIS TRAINING.
Additionally, dentists are used to

A

triage
identify burned or other unidentifiable bodies for identification/legal purposes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

YOU CAN’T CONTROL THE NEEDS/DESIRES OF PATIENTS
BUT: You DO need to perform a

A

“type of TRIAGE” to determine
their condition and Tx needs. (don’t just staple a black tag to
their forehead & walk off)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

It would be ideal to have every patient in your practice pursuing a
* However REAL LIFE gets in the way:
* Sometimes people are simply in the NEED of HELP

A

strict &
planned comprehensive dental program. (GOAL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What IF they are
actually having a Heart
attack, Diabetic crisis,
Asthma attack etc. and
only THINK they have a
toothache ???
#1 priority:

A

SYSTEMIC PROBLEMS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How you handle it is up to you:
* If you are in PAIN; you want ACTION RIGHT NOW
* You want HELP with an unplanned complication
* You may be in a situation where you know you have neglected health
* You may be in a situation where you don’t have the $ to proceed
* You may be in a situation where you can’t take the time off work

Life may have dealt you a whole bunch of problems which comprise multiple glowing embers any of which can erupt into a raging emergency at any time. (You may have NO EMERGENCY FUND)
This may be one of those times and the last thing patient wants is advice or counseling:

A

Don’t Preach: Don’t Educate. . . “JUST STAMP OUT THE CURRENT FIRE”
You COULD refer them to someone less busy; you don’t have to do it all. Just provide a path (Call D. Society)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

HOW CAN YOU HELP THIS PERSON?
* You MUST START with a —
* You MUST START with a thorough & appropriate —
* You MUST PERFORM appropriate —
* You MUST develop an accurate —
* You MUST envision an appropriate —
It doesn’t take an hour and
a half to get this done

A

HEALTH HISTORY.
EXAMINATION/STUDIES
CLINICAL TESTING/RADIOGRAPHS
DIAGNOSIS
TREATMENT PLAN (with OPTIONS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DECIDE WHAT OPTIONS EXIST:
* Present ALL OPTIONS in clearly understandable —
* Present the — in simple terms
* Don’t FORGET to appraise the PATIENT of THEIR —

A

LANGUAGE
RISKS & BENEFITS
Responsibilities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Don’t FORGET to appraise the PATIENT of THEIR Responsibilities
* — required for each option
* — required for each option (availability of TX and # of visits, etc.)
* — required for each option
* Expected (2) for each option

A

Costs
Time
Maintenance
Prognosis and Longevity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ONLY NOW CAN YOU ASK THE PATIENT TO BECOME INVOLVED in his/her
treatment as regards their desires and expectations. The — drives the
bus, and they must be fully informed and then they must make their
decision regarding which option they wish for their TREATMENT
(if mentally capable)

A

patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

BEWARE of some COMPLICATIONS:
* The patient MUST —
* The patient MUST HAVE reasonable —:
* The treatments must be professionally —

A

UNDERSTAND (or no permission for Tx exists)
expectations
reasonable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The Professional must be responsible to avoid
— options in presenting to the patient.

A

untoward/unreasonable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The Professional must be responsible to avoid
untoward or unreasonable options in presenting to the patient
(5)

A
  • IS THE TOOTH STRATEGIC AND FUNCTIONAL?
  • IS THE TOOTH REASONABLY RESTORABLE?
  • IS THERE A PERIODONTAL SITUATION WHICH IS COMPROMISING?
  • ARE THERE OTHER QUESTIONABLE INVOLVEMENTS?
  • IS THE TREATMENT REASONABLY AVAILABLE?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

It doesnt take an hour and a half to get this done:

A

time is our most precious resource

21
Q

IS THE TREATMENT REASONABLY AVAILABLE?
Has to be done in Advanced Endo $ + Wait?
Must have crown-lengthening + post and build-up Buildup and crown
Patient leaving the country in 3 days
Patient has to travel 200 miles to get here
Patient can’t get off work or has no $

A

adv endo
build up and crown
travel
cost, time

22
Q

WHEN THE PATIENT REASONABLY
DECIDES:
* AND THE EMERGENCY TX IS COMPLETED & PATIENT COMFORTABLE.
* THEN YOU CAN LECTURE TO THEM ABOUT

A

THE BENEFITS OF COMPREHENSIVE DENTAL CARE & MAYBE THEY WILL CHOOSE TO BECOME YOUR REGULAR PATIENT & MAYBE THEY WILL CHOOSE TO
WAIT FOR THE NEXT EMERGENCY TO OCCUR. OR NOT. YOU CANNOT FORCE THEM.

23
Q

WE DO HAVE MORAL, ETHICAL AND PROFESSIONAL OBLIGATIONS:
* We may NOT begin treatment and then fail to complete same & we may NOT propose to offer to provide any treatment for which we are not qualified. Nor may we refer the patient to anyone whom —
* We may NOT refuse to provide treatment to the patient for any reason covered by a —
* We MAY refuse treatment to any patient for any reason not covered as a —
as long as we —

A

we do not know to be qualified.
federally “protected group”.
federally “protected group”
have not begun any treatment.

24
Q

NOW that we have defined the playing
Field:
* How CAN we help the patient effectively & efficiently in an emergency?
(3)

A
  1. Patient having Symptomatic Irreversible Pulpitis but no PA sensitivity, no
    no PARL and no swelling no fever.
  2. PULP EXPOSURES
  3. Patient having Symptomatic Irreversible Pulpitis (or AIP or Necrotic
    Pulp) WITH PA sensitivity, PARL and swelling or fever.
25
Q

Want to make a new:
(3)

A

Friend
Patient
Disciple

26
Q

Help a person escape from PAIN:
(3)

A

Help a person escape from PAIN:
* Best practice builder ever!
* Instant trust
* Even YOU will feel better for helping

27
Q

ANY Tooth with Irreversible Pulpitis or PA
Pathology of Endodontic Origin is Best
Treated by —
constraints (3)

A

TOTAL Pulpectomy and RCT.

  • TIME CONSTRAINTS:
  • $ CONSTRAINTS:
  • Other CONSTRAINTS:
28
Q
  • “EMERGENCY” TX: MEANS - Do the best we can to stop the pain at
    the time -until we have time to do the complete RCT. (If we accept
    the case).
    If we BEGIN any Tx,
    If we DON’T COMPLETE it;
    If we DON’T begin any Tx;
A

we are bound to complete the Tx.
we can be charged with “Abandonment”
we can REFER & avoid the Liability

29
Q
  1. Patient with Symptomatic Irreversible Pulpitis but no PA
    involvement, no PARL & no swelling nor fever. (NOT sens.
    to PERCUSSION)
    Tx:
A

emergency
Vital Coronal Pulpotomy

30
Q
  1. Patient with Symptomatic Irreversible Pulpitis but no PA
    involvement, no PARL & no swelling nor fever. (NOT sens.
    to PERCUSSION
    Expected Outcome:
    (4)
A
  • Absence of presenting pulpal
    pain
  • Should remain comfortable
    for a short period of time
    until canals become necrotic
  • Make appointment in Endo.
    (Undergrad or Advanced) prn
  • Will require RCT & Crown at
    a later date.
    EMERGENCY TREATMENT
31
Q

2a. Asymptomatic Vital Pulp Exposure (without Pain):
(3)
Next:

A

Deep Caries
Vital Pulp exposure
Clean & Covered

Cover with cotton
pellet and restore using
Paracore + 2
Radiographs

32
Q

2a. Asymptomatic Vital Pulp Exposure (without Pain):
HOW TO:
(7)

A
  • DO ALL CLINICAL TESTING & RECORD (TEST AT LEAST 3 TEETH AS “BASELINE”)
  • FILL OUT ENDO. DIAGNOSIS FORM (BEFORE O&R IF PULP EXPOSURE MAY OCCUR)
  • ISOLATE TOOTH IN QUESTION WITH DENTAL DAM
  • REMOVE ALL CARIES & UNSUPPORTED ENAMEL (If pulp is exposed)
  • DISINFECT WITH 8.3 % NaOCl and ARREST HEMORRHAGE, PULPCAP EXPOSURE WITH DYCAL & COTTON
    & PLACE TEMPORARY RESTORATION SUCH AS PARACORE
  • AFTER RESTORATION, TAKE 2 RADIOGRAPHS ( 1 STRAIGHT-ON AND 1 AT 20 DEGREE SHIFT SHOT)
  • CONTACT ANY ENDO FACULTY ON EXCHANGE E-MAIL (SUBJECT OF E-MAIL IS “PULP EXPOSURE”)
    INCLUDE PATIENT NAME & CHART #, TOOTH INVOLVED AND BRIEF HISTORY.
33
Q

2b. Asymptomatic NON-Vital Pulp Exposure (without
Pain):
HOW TO: (SAME AS VITAL)
(7)

A
  • DO ALL CLINICAL TESTING & RECORD (TEST AT LEAST 3 TEETH AS “BASELINE”)
  • FILL OUT ENDO. DIAGNOSIS FORM (BEFORE O&R IF PULP EXPOSURE MAY OCCUR)
  • ISOLATE TOOTH IN QUESTION WITH DENTAL DAM
  • REMOVE ALL CARIES & UNSUPPORTED ENAMEL (If pulp is exposed)
  • DISINFECT WITH 8.3 % NaOCl and ARREST HEMORRHAGE, PULPCAP EXPOSURE WITH DYCAL & COTTON &
    PLACE TEMPORARY RESTORATION SUCH AS PARACORE
  • AFTER RESTORATION, TAKE 2 RADIOGRAPHS ( 1 STRAIGHT-ON AND 1 AT 20 DEGREE SHIFT SHOT)
  • CONTACT ANY ENDO FACULTY ON EXCHANGE E-MAIL (SUBJECT OF E-MAIL IS “PULP EXPOSURE”) INCLUDE
    PATIENT NAME & CHART #, TOOTH INVOLVED AND BRIEF HISTORY.
34
Q

Symptomatic Vital or Non-VITAL Pulp Exposure
(with Pain):

A

Place Cotton and Cavit and refer to
E-Chair or Endo as indicated by
symptoms

35
Q

Symptomatic Vital or Non-VITAL Pulp Exposure
(with Pain):
HOW TO:
(5)

A
  • Remove all caries & unsupported enamel
  • Disinfect & arrest any hemorrhage with NaOCl
  • CALL FOR Endo. Consult (No treatment will be provided by Endodontist doing consult)
  • Possible Pulpotomy or Pulpectomy in E-Chair (RESTORATION AS REQUIRED)
  • Make appointment in Endo. (Undergrad or Advanced) as indicated BY CONSULT
    Deep Caries Vital Pulp exposure Clean& Covered Vitrebond
36
Q
  1. Symptomatic Apical Periodontitis
    (with or without Symptomatic Irreversible
    Pulpitis):
    If you identify apical periodontitis of endodontic origin especially in multi-canaled teeth, you may have any combination of —

However, you can be CERTAIN WHEN WE HAVE
PERIAPICAL INFLAMATION of PULPAL ORIGIN that Emergency Tx will only be effective with
—

A

pulpal activity from “normal” through inflamed & infected to
necrotic (may have PARL or not yet visible).

complete pulpal extirpation (pulpectomy) and that RCT is indicated for this tooth in the
near future.

37
Q
  1. Symptomatic Apical Periodontitis
    (with or without Symptomatic Irreversible
    Pulpitis):
    Expected Outcome:
    (4)
A

-Immediate cessation of pulpal pain.
-Tooth will remain sensitive to percussion and
biting for up to 3 days
- Make appointment in Endo.
(Undergrad or Advanced) prn
- Will require RCT & Crown

38
Q

EMERGENCY PULPECTOMY TECHNIQUE:

A
  • Gain Adequate Analgesia & Isolate tooth
  • Access and locate canals
  • Use apex locator and #10 file to find patency
  • Enlarge 1mm. Short of patency with a #15 file
  • Enlarge 2mm. Short of patency with a #20 file
  • Enlarge 3mm. Short of patency with a #25 file
  • Irrigate copiously between each instrument with 8.3% NaOCl
  • Dry with paper points and place CaOH in all canals, cotton and IRM.
  • Help patient obtain appointment in Pre-doc endo or Advanced endo as indicated
39
Q

This tooth is SENSITIVE To BITE and SWALLOW:
We swallow 3000 x daily = 3000 pains
Would this be a good time to REDUCE the —?
Would you want to do this B4 you put the — ON?
Would you want to wait and do it LATER when you foul up your —?

A

OCCLUSION
DAM
Working Length

40
Q

EMERGENCY PULPECTOMY TECHNIQUE:
BENEFITS:
(4)

A
  • removal of irritants, toxins and substrate
  • path to patency obtained & retained
  • allows NaOCl to WORK
  • provides space for CaOH
41
Q

How MUCH of this are YOU willing & able
to do?
* — to the rescue!
* Do YOU want to ASSUME the —?
* Do YOU want to ASSUME the —?

A

CASE SELECTION
RESPONSIBILITY
LIABILITY

42
Q

Do YOU want to ASSUME the LIABILITY?
* Do you have the —?
* Do you have the —?
* Do you have —?
* WHAT IS BEST FOR THE —?
* What is BEST for Your Practice?
* Can you make $ doing it?
DEVELOP YOUR — PARACHUTE

A

Training & Skills
Facilities & Instruments/Supplies
TIME
PATIENT
REFERRAL

43
Q

Your radiograph may
look like this and your
patient (although
obviously in pain) shows
no extraoral swelling
localized swelling only
and no lymphadenopathy or
fever; you may elect to
do I & D in the office
and/or open the tooth
for pulpectomy.
If you open into the pulp, you may be greeted by a fountain of pus followed
by blood and finally serous fluid. Following pulpectomy and shaping, You
should then —
Patient’s pain will
be greatly reduced
by these easy
treatments and RCT
can later proceed as
usual.
If the swelling is fluctuant; it may be
prudent to incise the most dependent
portion of the swelling.
THIS WILL OFTEN —
Place the patient on —
mg. of ibuprofen q 4-6 h.
for 1-3 days.
Be sure to call the patient
that evening after to see
how well they are doing.
Tx them the next day if
fluid from the tooth was
copious & difficult to dry.

A

dry the canals and close with CaOH, cotton and temp. filling.
GAIN IMMEDIATE
RELIEF FROM THE SEVERE PAIN
600

44
Q

You might have the exact same
radiographic image but the
patient comes in looking like
this with extreme extra-oral
swelling, obvious cellulitis, and
spiking fever and exquisite pain
Remember: NEVER try
to diagnose from the
— alone. You
MUST EXAMINE the
patient!
You are NOT TRAINED to treat
this extremely acute problem
which is life-threatening.
Call your oral surgeon friend
or ER and get this patient
admitted to the Hospital at
once.
This is AT LEAST a
— &
VERY SERIOUS!
In HOSPITAL: This patient was having difficulty in deglutition
and also in breathing. As you can see, an emergency
tracheotomy was done STAT to save his life and restore
respiration. It turns out to be

A

radiograph
Submandibular Cellultis
“Ludwig’s Angina” and shows
the 3 drains necessary to treat the 3 fascial spaces involved.

45
Q

“Ludwig’s Angina” and shows
the 3 drains necessary to treat the 3 fascial spaces involved.
.
Concern at this point is
keeping the patient alive;
Move Quickly & Correctly
YOUR CHALLENGE IS TO
KNOW THE DIFFERENCE
AND BE ABLE TO DO A
TYPE OF DENTAL
TRIAGE AND MOVE
RAPIDLY TO INSURE
THE HEALTH OF THE
PATIENT.
Involves:

A

Submandibular space
Sublingual space
Submental space

46
Q

Ludwig’s Angina: Life Threatening
Be especially vigilant with infections of mandibular molars (especially 2nd & 3rd Molars) WHY:

A

2nd & 3rd
Molars often are located with their root apices located inferior to the mylohyoid M. therefore,
allowing ready access for infection to enter the submandibular space encouraging cellulitis to
occur in that space and also in associated fascial spaces.

47
Q

What about CAA? (RARELY AN
EMERGENCY)
Identified by DST:
WHY?
In the illustration shown, you may only need to assure that the DST is open
and actively draining and prescribe warm —. Then you may
proceed with RCT/Crown if total situation justifies the procedure.
In certain cases, the ostium of the DST may become closed causing localized
swelling and discomfort and a simple — may be required as emergency Tx
before proceeding to RCT.

A

Patient is generally comfortable and pain medication and
antibiotics are NOT indicated for the healthy patient.

intraoral rinses
I&D

48
Q

What about CAA?
CAA may appear on the surface of the face
TREATMENT

A

IS THE SAME; TREAT THE CAUSE (RCT)
You don’t need a plastic surgeon

49
Q

What about Deep Caries - Rev.or Irrev.
Pulpitis?
You MUST do your Sensibility Testing to determine if you are
dealing with (3)

ACCURATE
DIAGNOSIS suggests
CORRECT
TREATMENT
Rev. Pulpitis:
IRREV. PULPITIS:
Necrotic Pulp:
PULP Capping is ONLY an — for
(2)

A

reversible pulpitis, irreversible pulpitis or necrosis

Symptomatic Treatment
RCT or T.E.
RCT or T.E.

INTERIM TREATMENT
IRREV. PULPITIS or NECROTIC PULP

Endodontics 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions