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Definitions
Medical Emergency
Definitions
Symptom
Something the patient tells you about how he/she feels such as I feel dizzy or My arm hurts.
Definitions
Sign
Something that you observe in a patient such as increase in respiration or pallor. Signs are considered more reliable than symptoms as they are observed rather than described.
DENTAL EMERGENCIES
Syncope
AKA fainting. A temporary loss of
consciousness caused by insufficient blood to the brain Possibly the most frequent medical emergency in the dental office
Syncope
Causes
Surprise Emotional distress Pain Symptoms Pale, clammy skin Rapid, weak pulse Decreased blood pressure
Syncope
Treatment
Place the patient in a supine position with the feet elevated to a position higher than his/her head (trendelenberg position) Establish an airway and loosen any constricting garments Administer oxygen
Syncope
Treatment (contd)
Monitor and record the patients blood pressure and other vital signs If the patient has not revived within 10 - 15 seconds, remove oxygen and use ammonia inhalants.
Postural Hypotension
Abnormally low blood pressure. An
alteration of consciousness that can occur when a patient position too quickly. Caused by prolonged seating of patient in supine position during treatment then suddenly placing him or her in upright position
Postural Hypotension
Most often seen in patients receiving
Postural Hypotension
Signs and symptoms
Low blood pressure Patient is dizzy and appears disoriented Loss of consciousness
Postural Hypotension
Treatment
Return patient to supine position Establish an airway Slowly return patient to upright position If patient does not recover, call for assistance Monitor and record vital signs
Medical Emergencies
Respiratory Emergencies
Hyperventilation
An increase in the frequency and/or depth of respiration resulting in too much oxygen Usually occurs in patients that are extremely frightened or apprehensive of dental care
Respiratory Emergencies
Hyperventilation
Signs and symptoms Rapid, shallow breathing Lightheadedness Tightness of the chest Rapid heartbeat
Respiratory Emergencies
Hyperventilation
Treatment
Place the patient in a comfortable position Calm the patient Have the patient breath into either cupped hands or a paper bag
Respiratory Emergencies
Airway obstruction
Respiratory Emergencies
Airway obstruction
Signs and symptoms Patient grasps for throat High pitched sound when attempting to breath Ineffective or inability to cough Change in skin color
Respiratory Emergencies
Airway obstruction
Treatment Call for assistance and administer abdominal thrusts If coughing and has good air exchange, encourage to continue to cough
Cardiac Emergencies
Angina pectoris
Caused by narrowing of the coronary arteries that decreases blood supply to the heart and is usually brought on by physical exertion or stress Symptoms closely resemble myocardial infraction but usually only last 3-8 minutes and are relieved by rest or nitroglycerine
Cardiac Emergencies
Angina pectoris
Signs and symptoms Tightness or pressure in chest Pain often radiates to left shoulder, mandible, or left side of face
Cardiac Emergencies
Angina pectoris
Treatment Call for medical assistance Position the patient in the upright position Assist the patient in placing a sublingual nitroglycerine tablet or translingual spray
Cardiac Emergencies
Angina pectoris
Treatment (contd) Administer 100 % oxygen Record and monitor vital signs
Cardiac Emergencies
Acute Myocardial Infarction (AMI) or
heart attack Complete blockage of a coronary artery (infarct) that deprives part of the heart of blood
Cardiac Emergencies
AMI
Signs and symptoms Crushing sub-sternal pain that radiates to the left arm, jaw or teeth, and is not relieved by rest or nitroglycerine Shortness of breath and sweating Nausea and vomiting
Cardiac Emergencies
AMI
Treatment Call for medical assistance Initiate CPR if patient loses consciousness Administer oxygen Prepare nitroglycerine Monitor and record vital signs
Hypoglycemia
Diabetic complications are related to
diabetes mellitus Insulin shock Causes Too much insulin in system Hyperglycemia Not enough sugar in system Hypoglycemia
Hypoglycemia
Signs and symptoms
Clammy, cool skin Mild tremor Headache Confusion Unconsciousness, coma, and death
Hypoglycemia
Treatment
Offer the patient food containing sugar (candy, orange juice, etc.) Notify a physician immediately
convulsions (seizures) or disturbances of consciousness Signs and symptoms Warning aura Patient loses consciousness Violent contractions/relaxation of muscles
Remove all items from the patients mouth Maintain the patients airway Protect the patient from injuring themselves Contact EMS upon onset of seizure
Allergic Reactions
An allergy is a heightened state of
reactivity in the body to certain substance Patients are questioned as to their known allergies - not always accurate
Allergic Reactions
Allergic responses manifest themselves
in two forms Localized allergic (cellular) response, usually slow to develop and mild Symptoms include itching, redness of the skin, and hives Call for assistance and prepare basic life support in case it is needed
Allergic Reactions
Anaphylaxis (systemic response) Life threatening allergic response and the patient can die within minutes of its onset
Allergic Reactions
Anaphylaxis (systemic response) Signs and symptoms Patient feels physically ill Nausea or vomiting Shortness of breath Irregular heartbeat Loss of blood pressure Loss of consciousness
Allergic Reactions
Anaphylaxis (systemic response) Treatment Call for medical assistance Place patient in supine position Initiate Basic Life Support (BLS) if patient becomes unconscious Administer oxygen Monitor and record vital signs
Preventive Measures
Practice and rehearse emergency
procedures CPR training every 2 years Emergency exercises Review patients medical history Patient management Comfortable, empathy, avoid trigger words, and place in supine position
ANY QUESTIONS ? ? ?
BOTTOM LINE
BE VIGILANT ABOUT YOUR SURROUNDINGS AND PATIENTS CONDITION.
Summary
Definition of Terms Syncope and Postural Hypotension Common Medical Emergencies Allergic Reactions Prevention Measures