Basic Guide to Medical Emergencies in the Dental Practice

Phil Jevon is Resuscitation Officer/Clinical Skills Lead at Manor Hospital, Walsall. He is a Resuscitation Council (UK) ALS, EPLS, ILS, PILS, NLS Instructor and is an Honorary Clinical Lecturer at the Birmingham School of Medicine

• Foreword ixAcknowledgements xAbout the companion website xi1 An overview of the management of medical emergencies and resuscitation in the dental practice 1Introduction 1Concept of the chain of survival 2Incidence of medical emergencies in dental practice 3General dental council guidelines on medical emergencies 4Resuscitation Council (UK) quality standards 5ABCDE assessment of the sick patient 6Medical risk assessment in general dental practice 7Principles of safer handling during cardiopulmonary resuscitation 8Procedure for calling 999 for an ambulance 10Importance of human factors and teamwork 11Conclusion 13References 132 Resuscitation equipment in the dental practice 15Introduction 15Recommended minimum resuscitation equipment in the dental practice 16Checking resuscitation equipment and drugs 20Checking resuscitation equipment following use 22Care, handling and storage of oxygen cylinders 23Conclusion 25References 253 ABCDE: Recognition and treatment of the acutely ill patient 26Introduction 26Clinical signs of acute illness and deterioration 27The ABCDE approach 27General principles of the ABCDE approach 28The ABCDE approach to the sick patient 28Principles of pulse oximetry 34Procedure for administering oxygen to the acutely ill patient 38Procedure for recording blood pressure 41Medical emergencies in the dental practice poster 44Conclusion 46References 464 Respiratory disorders 48Introduction 48Management of acute asthma attack 49Management of hyperventilation 55Management of exacerbation of chronic obstructive pulmonary disease 56Procedure for using an inhaler 57Procedure for using a spacer device 61Conclusion 64References 645 Cardiovascular disorders 66Introduction 66Management of angina 67Management of myocardial infarction 69Management of palpitations 73Management of syncope 74Conclusion 76References 776 Endocrine disorders 78Introduction 78Management of hypoglycaemia 78Procedure for blood glucose measurement using a glucometer 83Management of adrenal insufficiency 85Conclusion 86References 867 Neurological disorders 88Introduction 88Management of a generalised tonic–clonic seizure 88Management of stroke 93Management of altered level of consciousness 96Procedure for placing a patient in the recovery position 97Spinal injury 101Conclusion 102References 1028 Anaphylaxis 104Introduction 104Definition 105Incidence 105Pathophysiology 105Causes 106Clinical features and diagnosis 107Treatment 109Risk assessment 113Conclusion 114References 1159 Cardiopulmonary resuscitation in the dental practice 117Introduction 117Resuscitation Council (UK) automated external defi brillation algorithm 118Procedure for cardiopulmonary resuscitation in the dental chair 118Procedure for performing chest compressions 126Conclusion 129References 13010 Airway management and ventilation 131Introduction 131Causes of airway obstruction 132Recognition of airway obstruction 132Simple techniques to open and clear the airway 133Use of oropharyngeal airway 135Principles of ventilation 138Treatment of foreign body airway obstruction 147Conclusion 150References 15011 Automated external defibrillation 152Introduction 152Ventricular fi brillation 153Physiology of defi brillation 153Factors affecting successful defi brillation 154Safety issues and defi brillation 155Procedure for automated external defi brillation 155Conclusion 158References 15812 Paediatric emergencies 160Introduction 160ABCDE assessment of a sick child 161Principles of paediatric resuscitation 162Placing a child into the recovery position 170Management of foreign body airway obstruction 170Conclusion 173References 17313 An overview of emergency drugs in the dental practice 175Introduction 175Adrenaline 176Aspirin 179Glucagon 180Glyceryl trinitrate spray 181Midazolam 182Oral glucose solution/tablets/gel/powder 185Salbutamol inhaler 185Conclusion 187References 18714 Principles of first aid in the dental practice 189Introduction 189Priorities of first aid 190Responsibilities when providing first aid 190Assessment of the casualty 190Wounds and bleeding 195Minor burns and scalds 200Poisoning, stings and bites 200Importance of record keeping 202Summary 203References 20315 Professional, ethical and legal issues 204Introduction 204The scope of a dental professional’s accountability 205The fifth sphere of accountability 217Legal requirements for consent and acting in a patient’s best interests 218Duty of confidence owed to patients by dental professionals 226Conclusion 231References 232Index 235