What is a Medical Emergency in the Dental Office?

Learn what defines a medical emergency dental from an expert's perspective - what causes it & how it can be prevented & managed.

What is a Medical Emergency in the Dental Office?

A medical emergency in the dental office can be an unexpected event that can include accidental or deliberate bodily injury, central nervous system stimulation and depression, respiratory and circulatory disorders, as well as allergic reactions. The body's response to stress can cause blood to pool in the extremities, a physiological process known as the fight or flight response. 7 However, the accumulation of blood is not helpful, especially when the person is in the dental chair. Due to the position and lack of mobility in the chair, oxygenated blood is pumped to the brain, which causes syncope.

7 Whatever the cause, the dental professional who suspects that a patient has presyncope should immediately and calmly place the patient in the Trendelenburg position (the head below the heart and the feet raised 10 to 15 degrees). Once the patient recovers, the provider and the patient will determine if treatment should be discontinued. It is recommended to monitor the patient before discharge. In many cases, it's wise to have a friend or family member take the patient home and monitor them until they return to normal. Provide procedures for the prevention and management of medical emergency situations in the clinics of the School of Dentistry.

Accepted patient evaluation techniques will be used to properly identify and treat patients at high medical risk. In the event of a serious medical emergency, the approved protocol for managing the emergency will be followed. Minor medical emergencies, such as cuts, burns, and chemical exposures that require first aid, will be managed in accordance with the University of Washington's safety policies. Documentation of medical emergencies will be made in accordance with the School Safety and Quality Improvement Program and, where appropriate, with state law. All providers should familiarize themselves with the location and contents of the first aid kits and emergency equipment available in clinics. For sites where conscious parenteral or multi-drug sedation is administered, additional equipment and emergency medications are required for ACLS (i.e., OMFS, Period, clinic for the elderly, & (dental fears).

Emergency medical procedures (which may be life-threatening) In any situation where a loss of consciousness or other possible medical emergency is suspected, the following procedures should be instituted in sequence. The protocol is published in each cubicle of the clinic and is updated annually (Appendix A).Minor injuries during patient care Bodily Fluid Exposure Procedure for Dental Students, Staff, and Faculty B. Minor injuries not related to patient care C. Maintaining the first aid system A designated person will be designated in each clinic, who will be responsible for maintaining the first aid kits in your clinic.

The Director of Safety is responsible for organizing ongoing training throughout the school. In accordance with the school safety program, all patient injuries and medical emergencies will be reported to the OCS within five business days of the incident. Use the event report form in Appendix B for such reports. The OARS notification system should be used in case of accidents and medical emergencies for students and employees. Dental Disciplinary Board reports: All students, faculty and staff dedicated to direct patient care must receive a “basic life support” certification at least every two years. All employees are encouraged to receive training on “basic life support”, even if they are not involved in patient care.

This training can be useful in providing emergency assistance to co-workers, school visitors, and family members. Appendix A, Emergency Medical Procedures Appendix B, patient event report Joel Berg, dean of the University of Washington School of Dentistry. Please enable JavaScript in your browser and try again. While prevention of medical emergencies should be a primary objective, it is nearly impossible to predict and prevent all emergency scenarios. The next level of training that dentists can receive is advanced cardiac life support (ACLS), which deals with advanced techniques that save lives such as intubation, defibrillation, intravenous access, administration of emergency medications and recognition of cardiac arrhythmias.

An office could be in a difficult situation from a medical-legal point of view if a patient were harmed during dental treatment due to lack of emergency resuscitation equipment recommended by Reanimation Council (United Kingdom) or emergency medications recommended by NICE in dental section of BNF. The next available person (P) will have task of going to hallway in search of an emergency car, preparing emergency medications or anything else that P1 decides. Effective emergency management requires team approach and that all personnel play key role during an emergency. The revised and updated poster “Medical Emergencies in Dental Office” is designed to be an aide-memoire that helps dental team manage medical emergencies safely and effectively. The team should also be familiar with all emergency medical equipment supplies and medications in office's emergency kit. If dentist is able to alleviate patient's concerns and use appropriate pain management techniques then an important step has been taken to prevent an emergency.

All emergency situations require team leader; this structure is no different from that adopted in emergency rooms where person is appointed to oversee entire patient care process give all orders and direct people to perform various tasks. The “Medical Emergencies in Dental Practice” section of National Institute for Clinical Excellence (NICE) 9 British National Form (BNF) 9 provides guidelines on treatment of most common medical emergencies that may arise in dental office. Have contact number for this person at reception desk along with other emergency numbers such as one for ambulance emergency room or local hospital.

Mía Walker
Mía Walker

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