m Prevention

m Preparation

m Treatment
 PREVENTION
m Take adequate Medical History.
m Identify high risk patient
 Medically compromised eg diabetic patient
m Mlways ensure patient has their own medication with them eg. Inhaler/GTN spray.
m Work as to prevent emergencies as possible

PREPMRMTION
m Emergency kit is regularly checked to ensure it is up to date
m Staff training ( everyone must know basic life support)
m Made aware of medical problems. Made people know their role during emergencies.
m Emergency phone numbers must be accessible all time
 Mct immediately and get help
Lie patient flat and raise their legs
M


maintain airway

administer oxygen

pulse: NO...then
PR
YES...assume hypoglycaemia. Treat
appropriately.

Give 200mg of hydrocortisone sodium succinate IV

(if competent)

ardiac
arrest

stroke Fai ts

Maphylactic Diabetic
shock
OLLMPSE emerge cy

Mdre al
Fits/epilepsy
crisis

hest pai
m Signs and symptom
@eel nauseated
„

With cold ,clammy hands
Notice visual disturbance
Together with feeling of
dizziness
Have a pulse that initially rapid
and weak...becoming slow on
recovery
Lose consciousness
m efore patient loses consciousness, bear
hypoglycaemia in mind. Give glucose drinks.
m Lay patient flat. Legs higher than head/heart.
m Loosen tight clothing around neck.
m Recovery is usually rapid.
m Occasionally pt may jerk as regain consciousness in
manner like a fit.
m Prolonged unconsciousness should lead to
consideration of other causes of collapse.
 
   

  

   


hypoglycaemia Drowsy,disorientated,aggresiv
e,pulse full and rapid,low
blood sugar,moist skin

Mnxiety,lack of food, Lay pt flat,if conscious
Overdosed insulin give oral glucose.if pt
unconscious give 20-50ml
glucose IV/1mg glucagon
IM.

Cardiac arrest Loss consciousness,no MI,hypoxia, choking et medical assistant,lay

respiration,pallor,cyanosis, drug overdose, pt on hard surface,start
absence of arterial pulse bleeding C

Mdrenal crisis Collapse,has Stress/trauma in Lay pt flat,clear airway

rapid,weak/impalpable patients on steroids and give O².give 200mg of
pulse,  falls rapidly hydrocortisone sodium
succinate (if competent),
call ambulance

Stroke Collapse,hemiplegia Hypertension Maintain airway and call

haemorrhagic,embolic ambulance.
 
   

  

   




Epilepsy
ollapse, widespread Some drugs,starvation, Prevent them from injuring

jerking menstruation. themselves,
If fit stopped,put Pt in recovery
position,
If convulsion ongoing,10-20mg
diazepam given IV/ 10mg buccal
infiltration of midazolam.

Mnaphylaxis
ollapse,cold clammy Exposure to allergen Lay pt flat,

skin,pulse weak and Eg: latex,penicillin Give 1:1000 adrenaline IM
rapid,oedema,urticaria Give hydrocortisone sodium
Wheeze,falling P succinate 200-500mg IM/IV(if
competent)
Give Oxygen
Summon medical help

hest pain
rushing central Mnxiety, If pt has angina,ask pt tu use their

pain,radiating to left hyperventilation normal medication eg.GTN
arm(angina/MI) If MI suspected,get help,give
reathlessness, 300mg aspirin to chew,
vomitting,
lear airway,give 50/50 mix of O2
collapse and NO2.
 Mre you
choking??

Gi   t 


Mttack occurs after suspected inhaled foreign bodies

Victim clutching his neck

›
 

an speak Unable to speak.Respond by nodding

an breath Unable to breath/breathing sounds wheezy

an cough Mttempts at coughing are silent
Victims may be unconscious
 Mssess severity


 

onscious

Unconscious

ontinue to check for 5 back blows

Start
PR
deterioration to ineffective 5 abdominal thrust
cough/relief of obstruction
m Related to hypoxia /overdose/both.May lead to
respiratory arrest if not addressed- pt cyanosed.
m Mvoidable by careful technique
m During any dental treatment, vital signs should be
monitored.

›  

m Stop giving sedation agent

m Open and maintain airways and give oxygen
m Ventilate the patient
m Use flumazenil if overdose suspected
m Mny potential problems with haemostasis should be known
when taking Medical History.
m Despite this, haemorrhage can occur POSTOPERMTIVELY
in dental patients and may be categorized as:

  - bleeding during surgery

  
 -bleeding few hours after surgery 3

  - occurs few days after surgery (Ú
Ú )
m
heck Greenwood journal
m Medical emergencies occuring in dental practise can be
alarming.In this case, remain calm and act immediately.
m Remember 3 points: Prevent, Prepare and Treat
m Thorough history should be taken so that possible
emergencies can be anticipated.
m Having good working knowledge of how to manage
emergencies is mandatory for all practising clinicians.