Medical Emergencies continued….. Chapter 31 in Torres Assignment: Fill in the blank and multiple choice in Chapter 31. Test on medical emergencies Review signs, symptoms, and treatments for all medical emergencies in M.D.A text.

Introduction A medical emergency is ___________________________________________________________________________________________________.

Preventing an Emergency Know Your Patient! Have open communication Have an updated medical history

Emergency Preparedness Assigned Roles Front Desk Staff 1. 2. 3. Clinical Staff

Emergency Preparedness-cont’d Dentist 1. 2. Routine Drills Training with mock emergency Learn each other’s roles Emergency Telephone Numbers 911 Local police Local fire station Emergency medical service Where should emergency numbers be located within the office? ___________________________

Recognizing a Medical Emergency Symptom: Define- Examples: Sign:

Emergency Care Standards Every member of the dental team must be current in: 1. 2. 3.

Emergency Care Standards Cardiopulmonary Resuscitation (CPR) ABCDs of Basic Life Support: Define A_______________________________________ B_______________________________________ C________________________________________________________________ D________________________ *2010 A-B-C order changed to C-A-B

Fig. 31-6 Standardized drug kit

Table 31-1 Drugs Used In Medical Emergencies

Emergency Responses Physical Changes Unconsciousness Altered consciousness Respiratory distress Convulsions Chest pain

Medical Emergencies Examples: Oxygen is always in a _________ cylinder or tank and is always safe to administer to the unconscious patient. All cells that make up the body require O2 and nutrients. Anytime there is a lack of either, the body will go into _____________. Examples: Heart attack Loss of blood Stroke Respiratory disorders (asthma) Diabetes (hyper- and hypoglycemia) Postural hypotension Allergic reaction (anaphylactic shock) Septic (infection) Note: aseptic means without infection

Common Medical Emergencies Syncope: A reduced blood flow to the brain causing the patient to lose consciousness. (fainting) Psychologic factors: 1. 2. 3. Physiologic factors: 4. Treatment: It is the most common medical emergency in the dental office and usually lasts 1-2 minutes.

Common Medical Emergencies Postural Hypotension: ______________________________________________________________________________________________________________ Treatment: 1. 2. Acute Myocardial Infarction: Commonly referred to as a__________________; the muscles of the heart are damaged because sufficient oxygen is not able to reach them.

Cardiac Emergencies Treatment: AnginaPectoris: ____________________________________________. Pain from angina usually lasts __ to __ minutes. Angina pain is relieved or eased promptly by the administration of a commonly prescribed drug,______________________. Treatment: 1. 2. 3.

Cerebrovascular Accident Stroke:____________________________ ____________________________________. Predisposing Diseases that can lead to a stroke. 1. 2. 3.

Breathing Problems Hyperventilation:_______________________________ ______________________________________________. The patient will usually remain conscious. Commonly caused by__________, ____________, __________, etc.) Treatment: Have pt. breathe into___________or _______________, or place oxygen mask over their face, without turning oxygen on. Bronchial Asthma: Attacks of sudden onset, during which the patient's airway narrows, causing difficulty in breathing as well as coughing and a wheezing sound. Causes: 1. 2. 3.

Allergic Reactions Allergy: An altered state of reactivity in body tissues in response to specific antigens. (foods, drugs, venom) Antigen: Antibodies: Localized Allergic Response: Slow to develop with mild symptoms such as itching, erythema, and hives. Anaphylaxis:__________________________________________________________________. Symptoms include:__________, _____________, _________,__________, _____________ Pt. May have a shortness of breath or loss of breath due to swelling of the larynx & obstruction of the airway. Skin will turn a bluish color. Treatment: 1. 2. 3. 4. What can these patients do to let others know of their conditions

Epileptic Seizures A neurologic disorder characterized by recurrent episodes of seizures. Petit Mal Seizure:___________________________________________ ___________________________________________________________ Grand Mal Seizure:__________________________________________ Phase 1: ______________________ Phase 2: ______________________ Phase 3: ______________________ Phase 4: ______________________ Treatment: 1. 2. 3. 4.

Diabetes Mellitus Define diabetes: Hyperglycemia: An abnormal __________in the glucose (sugar) level in the blood resulting in: _____________________ Signs: 1)__________, 2)____________, & 3) ______________________________

Diabetes Mellitus Hypoglycemia: An abnormal ____________in the glucose level in the blood due to: __________________________ Hypoglycemia may progress into_____________________. The patient may become unconscious due to too much insulin and not enough food. Signs: 1) ________), 2)___________, 3)_________, 4)__________, 5) ______________------ may have a wet, sticky skin Patient should be reminded to eat before dental appointment. Treatment: __________________________________________________ See diagram 31-11

Additional medical emergencies: Cardiogenic shock-_______________ Patient has severe pain. Treatment: Sit pt. Upright Administer 100% oxygen Call their physician

Additional medical emergencies: Pulmonary arrest- patient is not breathing. Treatment: Call 911 Begin artificial ventilation Drug addiction- How do you handle patients seeking prescription pain medications?

Additional medical emergencies: Hemorrhage- These patients usually require many blood transfusions, are at high risk for AIDS. Special care is required prior to treatment. Treatment: Clotting time assessment Replacement of blood factors missing Prophylactic antibiotic therapy Should have hepatitis B vaccine

Coagulant- an agent that promotes the clotting of blood Hemostatic drugs (clotting aids): Gelfoam- sponge placed in the alveolar socket Oxycel- placed dry into the socket Surgicel- guaze square placed into the socket Tannic acid- found in tea. Wet tea bag, place in 2x2 gauze and bite firmly

Documentation of an Emergency Full documentation of an emergency is essential. Include in the patient record: 1. 2. 3. 4. 5. 6.