1. Medical Emergencies in dentistry
General surgery
Medical Emergencies in dentistry
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Dr.Ziad H. Delemi
B.D.S., F.I.B.M.S. (M.F.)
Mosul university- College of dentistry-oral & maxillofacial surgery department

2. Respiratory difficulties
Medical Emergencies
Unconsciousness
Respiratory difficulties
Chest pain
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Mosul university- College of dentistry-oral & maxillofacial surgery department

3. Unconsciousness Syncope Shock Cardiac arrest Diabetic coma
Adrenal insufficiency
Convulsion
CVA
LA & drug toxicity
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Mosul university- College of dentistry-oral & maxillofacial surgery department

4. Syncope -Most commonly observed potentially life-threatening emergency
-Psychogenic shock or vasovagal attack
Trendelenberg position
Protect the airway
Monitor vital signs
Oxygen
If not resolved conservatively
-low blood pressure IV dextrose & Ringer lactate
+adrenaline 0.5mg IM, IV, SC.
-Bradycardia 0.4mg Atropine till 1.2mg
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Mosul university- College of dentistry-oral & maxillofacial surgery department

5. Syncope Psychogenic Fright Anxiety Emotional stress Pain Site of Blood
Nonpsychogenic
Prolonged sitting or standing
Hunger
Exhaustion
Poor physical condition
Hot humid crowded environment
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Mosul university- College of dentistry-oral & maxillofacial surgery department

6. Cardiac arrest -Airway (secure) -Breathing (mouth to mouth)
-Circulation (start CPR)
-Drugs (Dextrose + Ringer lactate
Adrenaline 1mg every 5minute
Sodium Bicarbonate 1mEq/Kg
Atropine 0.5mg every 5minute
Oxygen 10L/min.
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Mosul university- College of dentistry-oral & maxillofacial surgery department

7. Head-Tilt/Chin-Lift
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Mosul university- College of dentistry-oral & maxillofacial surgery department

8. Diabetic coma
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Mosul university- College of dentistry-oral & maxillofacial surgery department

9. Adrenal insufficiency
Adrenal crysis
Hydrocortisone 100mg or dexamethasone 4mg
Adrenalin 0.5mg
Oxygen 10L/min.
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Mosul university- College of dentistry-oral & maxillofacial surgery department

10. Convulsion hypoglycemia CVA Epilepsy Syncope drugs valium 5-20 mg IV
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Mosul university- College of dentistry-oral & maxillofacial surgery department

11. CVA
occur due thrombus or emboli that closed major artery in the cerebral circulation also called apoplexy or stroke
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Mosul university- College of dentistry-oral & maxillofacial surgery department

12. LA & drug toxicity Stimulation followed by depression Oxygen
Maintain blood pressure & pulse rate
Treat convulsion
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Mosul university- College of dentistry-oral & maxillofacial surgery department

13. Supine- check pulse check respiration Altered bizarre behavior
Unconsciousness
Supine- check pulse check respiration
Open airway
Full recovery
Syncope
(Psychogenic shock)
still
Altered bizarre behavior
No pulse
CPR
Cardiac arrest
There is pulse
CVA
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Alcohol overdose
Rapid
Insulin shock
Slow
Adrenal
insufficiency
Mosul university- College of dentistry-oral & maxillofacial surgery department

14. Respiratory difficulties
Respiratory failure (Heart failure)
Asthma
Foreign body
Allergy
Hyperventilation (HYS)
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Mosul university- College of dentistry-oral & maxillofacial surgery department

15. Respiratory failure Chocking Drug overdose (narcotics, sedatives, …)
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Mosul university- College of dentistry-oral & maxillofacial surgery department

16. Asthma Adrenalin 0.5mg Hydrocortisone 100mg Aminophylline 250-500mg
Ventoline inhaler
Oxygen
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Mosul university- College of dentistry-oral & maxillofacial surgery department

17. Foreign body Aspiration or swallowing -tooth -root
-endodontic instruments
-dental bur
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Mosul university- College of dentistry-oral & maxillofacial surgery department

18. Allergy Maintain airway, breathing Adrenalin 0.5mg every 5-10 min.
Hydrocortisone 100mg
Theophylline mg
Oxygen
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Mosul university- College of dentistry-oral & maxillofacial surgery department

19. Hyperventilation (HYS)
Anxiety
Most common
Metabolic conditions
Pain
Metabolic acidosis
Drug intoxication
Hypercapnia
CNS disorders
Treatment:
Terminate procedure
Position patient
Calm patient
Rebreathing bag
Sedation
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Mosul university- College of dentistry-oral & maxillofacial surgery department

20. Chest pain Myocardial infarction Angina pectoris hyperventilation
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Mosul university- College of dentistry-oral & maxillofacial surgery department

21. Myocardial infarction
Recognition
Airway
Breathing
Circulation
Oxygen L by NC or face mask
Monitor VS
Position to comfort
Pain relief
Morphine sulfate 2-5 mg IM/IV every 5-15 minutes
Controls pain and reduces anxiety
Prepare to perform CPR or provide
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Mosul university- College of dentistry-oral & maxillofacial surgery department

22. Angina pectoris Treatment Stop procedure Position patient to comfort
Oxygen 2-3 L per NC or face mask
Nitroglycerin 0.4 mg SL
Repeat every 5 minutes x 3 total doses
If no response, assume MI or unstable angina
transfer to ER
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Mosul university- College of dentistry-oral & maxillofacial surgery department