1. Dr. Suzan Hassan

2.  Many studies have shown that medical emergencies do occur in the dental practice so that we need to have appropriate skill and equipment available to deal with these conditions.

3.  Fainting (syncope).  Diabetic coma.  Anaphylactic shock.  Epileptic seizures.  Cardiovascular collapse.  Adrenal disorders.  Thyroid disorders.  Asthmatic attack.  Stroke.

4.  Sudden loss of consciousness.  Chest pain and dyspnea.  Convulsions( fits).

5. A\ Prevention includes:  Medical history questionnaire.  Documentation of vital signs.  Documentation of findings on medical alert Tags(patient medical file ).  Completion of physical assessment of the Pt begins with the first interaction with patient.

6.  Start with first interaction with Pt.  Note abnormalities of Pt voice on telephone during appointment scheduling.  Assess over all appearance when Pt enters the clinic.  Document findings in patient chart.  Physical assessment (signs & symptoms).  Comprehensive medical history.

7.  Medication has taken within 2 years.  Allergies and adverse drug reactions.  Medical emergencies had previously.  Vital signs (pulse, respiratory rate, blood pressure, temperature, weight).  Extra oral & Intraoral examination.  Comprehensive documentation of findings.

8.  Consider using pre medication or sedation.  Schedule morning appointment.  Eat breakfast or lunch before appointment.  Minimize waiting time.  Make sure to use adequate pain control.

9.  All staff in dental practice should have appropriate training of basic life support.  Basic Emergency procedures:  Monitor BP & Pulse.  Clear and maintain airway.  Cardiopulmonary resuscitation  Intravenous cannulation.

10.  PART II

11. Basic Life Support Ai r way breathing circulation

12.  A : open air way.  Use head tilt-chin lift.  Suction as necessary.  B :check for breathing  If not, give 2 breath via mask (100%).  Call for Automated Electronic Defibrillator(AED).  C : check for pulse  If no lay Pt flat and being chest compressions.  Apply AED.  If present check the rate.

13. Telephone Oxygen cylinder & mask Disposable airway Disposable syringe& needles.

14. IV cannulaeNebulizer of adrenaline Portable suctionAutomated Electronic Defibrillator(AED) Magill intubation forceps Alcohol swap& tape

15. Adrenaline1:1000 (0,5ml ampoules) Glyceryl trinitrate500mg Aspirin300mg hydrocortisone100mg chlorpheniramine10mg Salbutamol100mg (inhalar) Morphine sulphate10mg tablets Midazolam Glucagon Glucose or dextrose 10mg 1mg (ampoules) 50% (injection)

16.  Dental assistant:  Maintain A B C of CPR.  Place Pt in supine position.  Assess and record vital signs.  Dental Hygienist:  Bring emergency kit\oxygen to chair side.  Prepare medication for dentist.  Dentist:  Direct other team member and overall treatment.  Administer emergency medications.