W1,2,3 Medical emergency

Question 1

What is the role of a OHT in a medical emergency?

Answer 1

Manage symptoms
Call for help.
Maintain treatment until pt regains consciousness or assistance arrives

Question 2

Define Syncope?

Answer 2

Transient seelf-limiting loss of consciousness. Clinical manifestations:
spontaneous falling.

Prevelance ↑ with age and can caus significant morbidity in the eldery

Question 3

What is the managment of synope with a conscious pt?

Answer 3

Stop dental tx

• asses airways
• recline chair so pt is supine
• place pt in the recovery position
• monitor the pt pulse and bp
• Cool compress on their forehead.

CALL 000

Question 4

What is the management of chest pain?

Answer 4

Making the client comfortable.
- ANti anginal medication and angina management if patient has angina.

If no medical history of angina but reports pain may be worse acute MI.

Call for help 000, and rd bag.

• Monitor vital signs
• Give asprin 300mg chewed or swalling)
• Reassure pt.

Question 5

What is management of angina

Answer 5

If the patient is accustomd to treating their angina with their own medication.
If they dont have own medication (Glyceryl Trinitrate sublingually is a drug of choice to shorted the attack, and administration would be decidd on by the team.

Do no administrate directly yourself, assist pt. ** Glyceryl Trinitrate should NOT be administered within the 3-5 days of tadalafil (Cialis), or within 24 hrs of sildnafil (viagra) or vardnafil (Lvitra0

Question 6

How do you manage ocular chemical emergency?

Answer 6

Prevention: PPE.
Cause:
- Chemicals (irrigation solutions)
- Foreign bodies (calc, filling frag)
- Penetrating objects (burs, endo instru).

Cease dental tx.
Remove contact lensees.
Continud irrigation with eye opeen and exposd to water.
Arrange GP same day.
If moderate call 000

Question 7

What is the management of foreign body ocular emergency?

Answer 7

• Cease dental tx
• Do not touch y surface, do not attempt to remove.
• GP
• Arrange for transfer of pt/staff to emergency dep.

Question 8

What is a wheez regarding rspiratory symptoms?

Answer 8

Heard of expiration associated with asthma. Unreliable indicator of the severity of the asthma attack

Question 9

What is stidor?

Answer 9

Respiratory symptoms. TYpe of wheeze on inspiration - high pitched breath sounds. Common whn foreign body obstruction

Question 10

What are more symptoms of respiratory?

Answer 10

↑ use of accssory muscles

• Coughing spasms
• Altered level of concsiousnss

Question 11

What is the management of respiratory difficulties?

Answer 11

Breathing exercises.
If pt dos not have a known mdicale hx, get red bag and assistance, follow protocol for mild asthma attack.
Call 000

Question 12

What is hyprvntilation syndrome?

Answer 12

Pt ovrbreathing. Extremely common particularly in pts suffering anxiety, dental phobia etc.

Symptoms of hyprventilation confused with snycope, acute asthma attack or myocardial infarction Best observation pt, reassuring pt and listning to their neds

Question 13

What is the managemnt of hyprventilation?

Answer 13

Cease dental tx.
Reassur pt, to slow breath.
Cupping hands over mouth, breathing expired air.
Do no immediatly give oxygn.
If not responsiv call 000 & red bag.

Question 14

What is an acute asthma attack?

Answer 14

Can b fatal.
Evaluate severity of symptoms
nsure pt brings bronchodilator if history.

DOCUMNT THE FOLLOWING: 
Types of medication use to manage asthma,
- Asthma action plan
- Triggers
- Last attack.

If symptoms of an asthma attach cas tx.

Question 15

How to manage a mild asthma attack

Answer 15

Instruct pt to tak 4 puffs of short acting bronchodilator inhaler via space. Take 4 braths in and out aftre each puff.
Wait 4 min
Repeat 4x4x4
- Asses pt

Question 16

How to manage moderate to sevree asthma

Answer 16

Call 000 and for red bag,
- 4x4x4 rule continue this method until assistance arrives, whilst giving oxygen continuously.
Consider asking principle dentist to administer salbutamol 5mg. (ventolin)

Monitor pt.

Question 17

What is the management of an inhaled or swallowed object ?

Answer 17

Prevention is paramount.
Cease dental tx. 
Check to identify if it is present in pt mouth or clothes.
If yes, remove it.
If no, sit pt upright.
- Check pt vital signs and symptoms 
Do not allow pt to at or drink.
Ask for chest radiograph
- Ask DA to search suction filters and tubing.

IF PARTIAL AIRWAY obstruction call 000.
- Relax, deep breathing.

Question 18

Define wheeze and it’s contraindications?

Answer 18

Heard on expiration, associated with asthma,

Contraindicated as it is not a reliable indicator.

Question 19

Define stridor

Answer 19

Type of wheeze on inspiration, higher pitched sound, Indicative of obstructd airways.

Question 20

What is thee management of wheeze and stridor?

Answer 20

Call for red bag and assistance. Follow protocol for mild asthma attack:
- 4x4x4 rule
- Temporise dental tx.
- Give 4 x puffs of short acting bronchodilator via spacer.
- 1 x puffs at a time.
( Pt ptakes 4 x breathin and out of the spacer each puff.
- Wait 4 min,
- 000 + red bag

Question 21

How do you manage hyperventilation?

Answer 21

It is over breathing. Observe pt, reassure and listen to their needs.
Cease dx.

Question 22

How do you manage inhaled or a swallowed object?

Answer 22

Prevention with gauze, floss, do not use if has a chance of falling into mouth - Sit the patient upright, do not allow pt to drink.

• Arrange chest x-ray
• Ask DA to search suction filters

Question 23

What is a characteristic of a stroke?

Answer 23

Weakness or numbness.

• Difficulty with movemnt on 1 side.
• Paralysis of the face/arm/leg or both sides.
• Blurred vision + headache + diff swallowing
• Tranisent loss of vision

Question 24

How would you manage a stroke?

Answer 24

Cease dx.
Call 000 + redbag
Give oxy
Maintain airways
Monitor vital signs

Question 25

What are the characterists of a stroke?

Answer 25

Can be a manifestation of a underlying conditions.
(epilepsy, syncope, stroke, hypoglycaemia, stroke, cerebral hypoxia, fever).
• Aura (seeing lights)
• Sudden muscl spasms
• Jerky movement
• Loss of consciousness

Question 26

How do you manage a seizure?

Answer 26

Status epilepticus (seizures without recovery) – call 000
Recovery position, make comfortable
Keep appointment short for pt
Clear obstructed airways
Don’t allow to drive home
Black out sunglasses for sensory seizurs (PREVENTION)

Question 27

What are the characteristics of hypoglycaemia?

Answer 27

Can occur at anytime.
Inappropriate ↑ does of insulin
Forgotten or delayed meals
Insufficient carbohydrates
Excessive alcohol
Unaccustomed exercise.
Andrenergic: pale skin, sweating, shaking, palpitations & anxiety.
Neuroglycopenic: hunger, suboptimal intellectual function, confusing, seizures.
Diabetic pts.

Question 28

How would you manage hypoglycaemia?

Answer 28

Obtain thorough med hex.
GLUCODIN!
Cease dx tx.
Fruit juice, lemonaid, jelly beans, honey – followed by sandwich or dry fruit.
Diabetic pts prefer MORNING appointments (5.6-6.9mmol/L) mini molarity blood per sugar (ask if they have eaten today.
<5mmol/L don’t perform tx.

Question 29

What are the characteristics of hypersensitivy reeactions

Answer 29

• Allergy
• Exaggerated response
PREVENTION
1. Skin: itching (uticardia), flushing, swelling (angioedema), hives
2. GIT: cramps, nausea, vomiting, incontinence
3. Respiratory: tightness in chest, wheeze
4. CVS: light headedness, ↑ HR, ↓ BP, loss of consciousness