1. RISK

2. Estimate of Disease 2008  Cardiovascular Disease4,212,800  Asthma2,049,700  Hypertension1,945,800  Diabetes818,200  Epilepsy138,800  Allergy - undefined1,029,500 © ABS National Health Survey Summary Results 2009

3. Death from Disease - 2010

4. Death from Non - Disease Causes - 2010

5. Death from Disease - 2010

6. Death in Care 2010

7. Presenting Problems  Sudden Collapse  Poor Perfusion (Shock)  Altered conscious state  Cardiac Chest Pain

8. Causes of Sudden Collapse  Two Main Causes  Most Common  Fainting  Most Dangerous  Cardiac Arrest

9. Comparison Cardiac Arrest Altered Consciousness Pale, Cold, Wet Skin No Pulse Altered Respiration Faint Altered Consciousness Pale, Cold, Wet Skin No Pulse Altered Respiration

10. Treatment  Lay patient flat  Check: Response, Airway, Breathing  Faints recover, cardiac arrest worsens  Immediately start chest compressions  Raise alarm  Get and use Semi Automatic Defibrillator  Insert LMA and begin IPPV

11. Causes of Poor Perfusion  Failure of the heart as a pump - Cardiac  Failure of circulatory system - fainting  Fluid loss – absolute or relative  Blood, Plasma, Water  Septicaemia  Anaphylaxis

12. Diagnosing Poor Perfusion  Two of four indicators present:  Conscious State is altered  Skin is pale, cold and wet  Respirations  25 a minute or faster  10 a minute or slower  Pulse  100 a minute or faster  50 a minute or slower

13. Treatment  Posture patient flat or for comfort  Oxygen at 8 litres per minute  Take observations and record ASAP  Call Ambulance  Prepare to manage unconsciousness

14. Chest Pain All chest pain is life threatening until you PROVE it is not!

15. Cardiac Chest Pain  Pattern  Half way between up the chest  Radiating to left neck, jaw or arm  May radiate to right neck, jaw or arm  Descriptive Words;  heavy, crushing, tight or dull ache  Uses broad hand gestures  Can’t put their finger on it

16. Cardiac Chest Pain All chest pain is life threatening till you PROVE it is not! Almost 14,000 will die in the first 60 minutes

17. Managing the Incident

18. Considerations  What equipment do we have available  Is it labour saving  Can it provide definitive care  S-AED, Adrenaline, Salbutamol  Training  Individual  Team  Time

19. The Process  Organise Equipment  Practice the response  Team effort  Keep the dentist free  Identify the presenting problem  Let the team do their job – Immediate Drill  Get a provisional diagnosis but never withhold treatment till you do.

20. Immediate Drill  Automatic Response by team  Identify problem,  Raise alarm and  Posture patient  Get gear, all of it - Bag to nurse, booklet to dentist  Oxygen on and applied appropriately  Purpose is to free dentist to make decisions

21. Deliberate Treatment  Specific treatment for the presenting problem or condition provisionally diagnosed by the dentist.  Taking and recording of observations  Ensuring patient’s condition is being improved or at least maintained by treatment

22. Cynergex Group Pty Ltd Providing OHS First Aid Medical Equipment & Services 37/2 Chaplin Drive Lane Cove NSW 2066 Phone: 02 9420 4699 Fax: 02 9420 4703 www.cynergexgroup.com.au