Claudia Marlene Ávila Islas.

During root canal therapy, a 68-year-old male patient becomes pale, perspires profusely, and clutches his chest.  He appears confused, and is now unresponsive to verbal stimuli.  He is not breathing and no pulse can be felt in the carotid artery. 

Do you know how to handle this situation?

Introduction.

Medical emergencies can occur at any time in the dental office.  They can happen to anyone, from the anxious patient in the reception room to the elderly diabetic who was told to skip breakfast prior to coming to her appointment.  

The best way to handle an emergency is to be prepared. 

Staff should be trained and frequently updated in first aid and cardiopulmonary resuscitation procedures.  A written emergency plan should be available

Preparation for Emergencies

Obtain a medical history on every patient and update it at each visit.

When confirming appointments, remind patients to take their normal medications on the day of their appointment

All staff members should be trained in basic first aid procedures and basic life support (CPR).

The office should have a written emergency plan, emergency telephone numbers should be posted at each phone.

Each office should have an emergency kit readily available and each staff member should know where it is located.

Health Assessment

One key to reducing risk is to take a health history and vital signs to identify the “at risk” patient.  In some cases, extensive procedures on “at risk” patients might are best performed in a hospital setting

The health history should include information regarding the patient’s past and present health status.

Vital Signs

Vital signs-blood pressure, pulse, respirations, and temperature-should be measured prior to each treatment.

Recognition of an Emergency and Initial Emergency Procedures

Physical signs and symptoms that may indicate an incipient medical emergency include chest pain, pale skin, sweating, vomiting, irregular respiratory rate, altered or unusual sensations, hemorrhage, and changes in pulse and blood pressure.

What types of emergencies can be expected in the

dental office?

Airway Obstruction.

Asthma/Bronchospasm

Cardiac Arrest.

Angina

AMI

Allergy

Emergency Kit

It has been estimated that one or two life threatening emergencies will occur in the lifetime practice of a general dentist. 

  Obtaining a health history and a set of vital signs is the first step in identifying the patient likely to develop a medical emergency.  With proper training, thorough preparation, and regular practice, the staff of the dental office will be able to provide appropriate medical care should the need arise.

Summary.