1. Medical & Dental Emergencies
Torres, Chapters 26, 27
Anderson, Chapter 10
Assignment: Review at the end of Chapter 10 &
Fill in the blank and multiple choice in Torres Workbook for Chapter 27

2. Chapter 26 in Torres: Introduction
The patient record is the principal
document that contains critical information you will need to manage each patient in the dental practice.

3. Prior to treatment, the dentist has to make a complete diagnosis.
Diagnosis- the act of identifying a disease from its signs and symptoms. The decision about treatment is reached by the diagnosis.
Prognosis- a forecast of the course of a disease or treatment.

4. Critical Information
Prior to dental treatment, the dental team must have the following information:
Patient Registration
Medical-Dental Health History
Medical Alert Information

5. The Patient Record Permanent Record Quality Assurance
A personal and legal document of the patient.
Quality Assurance
Primary source of information used by the dental team to determine the overall quality of care the patient has received.

6. Examples of Quality Assurance
Routine forms completed by each patient.
Timely recall of patients for their dental needs.
Completed patient record for each “active” patient.
Documentation of when radiographs were taken.
Current and up-to-date emergency standards maintained by the dental team.
Current and up-to-date licenses, registrations, and training.

7. The Function of the Patient Record-cont’d
Risk Management
Provides documentation of the patient’s condition, diagnoses, treatment, and the patient’s responses to treatment.
Research
The patient record provides a source of data for research purposes.

8. Patient Registration Form
Patient Information: full name, date of birth, residence, phone number, employment, spousal information
Insurance Information: employee’s name, date of birth, employers name, address, phone number, name of insurance, policy number
Responsible Party: person responsible for payment of account
Signature and Date: verifies the accuracy of information

9. Medical-Dental Health History Form
Medical History Section
Questions regarding the patient’s past medical history, present physical condition, chronic conditions, allergies, and current medications taken.
Dental History Section
Gains information about the patient’s previous dental treatment and care, and their feelings toward dentistry and how important dental care is to them.
The dentist or assistant may ask additional questions for more information: such as home remedies, herbs, or over-the counter medications, topical applications. Note acute and chronic illnesses.

10. Diagnostic signs evaluated by the dentist when examining a patient:
Pulse
Respiration rate
Blood pressure
Temperature
Skin color
Pupils of eyes
State of consciousness
Ability to move the extremities and other parts of the body
Reaction to stimuli
Breath odors

11. Medical Alert Information
Note to the dental healthcare team of medical conditions, allergic reactions, and medications that could interfere, or be life threatening to the patient during dental treatment.
Adhere an Alert Sticker to the inside of the patient’s record.

12. Health History Update
Patients must update their medical-dental health history at every appointment
Health information that may have changed:
Diagnosis of medical condition
Medications

13. Clinical Examination Form
Provides the dental team with past, present, and future examination, analysis, and charting needs of the patient.
Patient’s name and date of exam
Charting of existing restorations and present conditions
Charting of periodontal conditions
Patient’s chief complaint
Occlusal evaluations
Temporomandibular joint (TMJ) evaluations
Comments

14. Treatment Plan Form
Sequenced to address all problems identified during the examination and diagnosis portion of the patient visit.

15. Progress Notes Form
Section of the patient record where treatment is recorded.
Always include:
Date
Tooth number
Completed treatment
Signature

16. Informed Consent Form
Related to a specific treatment or procedure. A document that provides the patient with expected outcomes of treatment, and describes any possible complications that might occur.
Commonly used for invasive or extensive treatment, such as in specialty procedures.

17. Chapters 10 (Anderson) & 27 Torres: Vital signs
Attentiveness toward a patient’s immediate health should be the first priority of every health care provider.
Vital signs can provide you with a level of determining a patient’s health status and include temperature, pulse, respiration, and blood pressure.

18. Factors affecting Vital Signs
Emotional Factors
Stress
Fear
Physical Factors
Illness
Drinking or eating
Exercise

19. Temperature Temperature Readings Thermometer Types
Degree of the hotness or coldness of body
Temperature Readings
Average range for adult: 97.6–99° F
Body temperature higher in infant and child than adult
Thermometer Types
Electronic
Tympanic

20. Box 27-1 Average Fahrenheit (F) Temperature Readings for Primary Body Sites

21. Fig. 27-1 Digital thermometer

22. Fig. 27-2 Tympanic thermometer (Courtesy Welch Allyn, Skaneateles Falls, NY.)

23. Pulse A rhythmic expansion of the artery each time the heart beats.
Pulse Sites
Radial artery: inner surface of wrist
Brachial artery: inner fold of the upper arm
Carotid artery: alongside the larynx

24. Fig Location of the radial artery (From Kinn ME, Woods M: The medical assistant: administrative and clinical, ed 8, Philadelphia, 1999, Saunders.)

25. Fig Location of the brachial artery (From Kinn ME, Woods M: The medical assistant: administrative and clinical, ed 8, Philadelphia, 1999, Saunders.)

26. Fig Location of the carotid artery (From Kinn ME, Woods M: The medical assistant: administrative and clinical, ed 8, Philadelphia, 1999, Saunders.)

27. Pulse Characteristics
Rate: Number of beats
Rhythm: Pattern of beats
Volume: Force of beat

28. Pulse Characteristics-cont’d
Pulse Readings
Adult resting: beats per minute
Child: beats per minute
Irregularity
Arrhythmia: An irregularity in the force or rhythm of the heartbeat

29. Respiration The process of inhaling and exhaling, or “breathing.”
Respiration Characteristics
Rate: Total number of breaths per minute
Rhythm: Breathing pattern
Depth: Amount of air inhaled and exhaled
Respiration Readings
Adult: breaths per minute
Child to teenage: breaths per minute
Children require more oxygen.

30. Blood Pressure
The amount of work the heart has to do to pump blood throughout the body.
Two Pressures of the Heart
Systolic: Reflects the amount of pressure it takes for the left ventricle of the heart to compress or push oxygenated blood out into the blood vessels.
Diastolic: The heart muscle at rest when it is allowing the heart to take in blood to be oxygenated before the next contraction.

31. Box 27-2 Blood Pressure Classifications for Adults

32. Blood Pressure Equipment
Sphygmomanometer
Blood pressure cuff
Meter
Rubber bulb
Stethoscope
Amplifies sounds
Need pencil, paper and patient’s chart

33. Blood pressure: Is measured on the brachial artery
It can be done on either arm, just record the arm you are taking it on
Consider women whom have had breast cancer and had breast removed.

34. Fig. 27-8 Types of sphygmomanometers
Fig Types of sphygmomanometers. A, Aneroid (without liquid) dial system. B, Aneroid floor model. (From Young A, Proctor D: Kinn’s The medical assistant: an applied learning approach, ed 9, St. Louis, 2003, Saunders.) A B

35. Fig Stethoscope

36. Box 27-3 Five Phases of Korotkoff Sounds in Blood Pressure Measurement