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About 25% of those who have heart attacks do not realize they are having them.INTRODUCTION A heart attack occurs every 20 seconds. .

• The entire staff must be trained. • Emergency equipment and drugs must be available and current .PREPARATION • You must find out from patients any medical conditions or medications they are or have been taking. a designated in-office emergency team must also be trained.

If you do not know what is going on or are concerned about the situation. . call for help. When in doubt. The dentist is legally responsible during a medical emergency to keep the patient alive until he or she gets better or until someone who is better trained arrives on the scene to take over. call for help. Responsible for staying with the patient.The In-Office Emergency Team Team member 1: The person who first observes the emergency. Team member 2: The person who will get the emergency oxygen cylinder and emergency drug kit Team member 3: All other staff members. get it. Handle other tasks as assigned by the dentist during the emergency. Calling for Help If you think that you need help. performing CPR as needed.

2.EMERGENCY EQUIPMENT 1. Pocket Mask By holding the mask on properly and putting your mouth onto the mask. which is about three feet high and contains enough oxygen to ventilate a nonbreathing adult for approximately 30 minutes. can ventilate a person with 16% oxygen. . Oxygen Tank Oxygen must be available in an “E” cylinder.

Automated External Defibrillator (AED) Defibrillation is very important and is carried out by placing special pads on the torso that recognize a sudden cardiac arrest. .

is used to treat an acute asthmatic attack. not swallowed. Injectable Drugs Epinephrin e Diphenhydramine (or Benadryl) Nitroglycerin Noninjectable Drugs Bronchodilator Histamine blockers are used in the management of primarily non-life-threatening allergic reactions and anaphylactic reactions after epinephrine a vasodilator.DRUG KIT used when an anaphylactic reaction occurs. . Glucose (Sugar) Aspirin Secondary Drugs dosed in a 1:1000 (0.3 mg) concentration and must be available in a preloaded syringe Aromatic Ammonia One aspirin tablet (325 mg) chewed. usually in tablet form. must be included in the drug kit. is recommended in any patient who is suffering chest pain for the first time. Patients who have angina will bring their nitroglycerin with them.

Definitive P: supine position A: Headtilt chinlift B: check whether the patient is breathing C: Checking circulation D: diagnose the problem . Positioning patient A.Management of Medical Emergencies Conscious Patients Unconciou s Patiens P. Circulation D. Breathing C. Airway B.

feel • Not breathing  2 complete ventilation Circulation • Check the carotid artery for a pulse. No more than 10 sec • No pulse  chest compresion . listen.Airway management • Head Tilt/ Chin Lift Breathing • Look.

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SPECIFIC MEDICAL EMERGENCIES Symptoms: cold. Hypoglycemia “When did you last take your insulin?” “When did you last eat?” Conscious diabetic Management position comfortably. A. Definitive care is simply the administration of sugar. shaking. supine position Unconscious diabetic Check ABC No drug should be administered . sweaty. and C are not required. and mentally disoriented.B.

Maintain the patient’s airway by performing a Head Lift/Chin Tilt. listen. remove the doughnut or pillow from the dental chair.What type of seizure do you have? What medication(s) are you taking to control your seizures and how effective are they? What is your aura? Review Med History Have you ever had a seizure that did not stop? Have you ever been hospitalized for your seizures? If possible. Epilepsy The PABCD protocol Position the patient so that he or she cannot hit any sharp objects. check for the carotid pulse. . feel). Check for breathing (look.

Definitive care is simply to give the patient his or her own bronchodilator. Review Med History How often do you have asthmatic attacks? What triggers your asthmatic attacks? What are you allergic to? What medications do you take for your asthma? Asthma Have you ever had an asthmatic attack that didn’t stop and that requiredhospitalization? The PABCD protocol Patient is positioned comfortably. and breathing becomes extremely difficult. No need ABC because the patient is breathing (albeit with difficulty) and is conscious. .What type of asthma do you have? The airway is narrowed. For patient having an acute asthma attack : sit up.

usually involving the respiratory and cardiovascular systems and producing bronchospasm and a drop in blood pressure. allowing you to position them comfortably and move to definitive care If patients are unconscious. . place them in the supine position Immediate-onset allergies are life-threatening. tongue. and C until help is on the scene and to readminister epinephrine in approximately five minutes. and take any necessary action The PABCD protocol Immediately get the preloaded epinephrine syringe and give the injection in the deltoid.All patients will initially be conscious. Allergic Response: Anaphylaxis Assess airway and breathing. B. if necessary. or lateral thigh Be prepared to monitor A.

Angina Pectoris Position the patient comfortably PABCD protocol A. heaviness. and C need not be done Definitive treatment :give patients nitroglycerin. B. The average dose is two tablets placed under the tongue Chest Pain Myocardial Infarction (MI) A patient tells you that the pain is getting worse.tightness. Call EMS when Cardiac Arrest The patient takes nitroglycerin and the pain goes away but comes back. or a constricting feeling in the chest and will often make a fist and hold it against the chest to describe this. The patient takes three doses of nitroglycerin at fiveminute intervals and the pain doesn’t go away. A patient with no prior history of cardiovascular disease has chest pains for the first time .

and the patient may be sweating profusely. radiating pain Classic myocardial pain radiates from the chest into the stomach. position the patient comfortably PACB protocoll No need ABC Call EMS Immediately for definitive care Oxygen Nitroglycerin Manage with Aspirin: one dose. chewed . usually as a tingling sensation in the arm and pinkie finger. and may radiate to the left side of the patient’s neck and mandible. Myocardial Infarction Sign Symptom The mucus membranes may be cyanotic. giving a bloated feeling. The pain radiates down the left arm.conscious feels crushing. The patient’s skin is normally an ashengray color. intense.

Notified EMS Performing onerescuer CPR at a ratio of 15:2 Carotid pulse is checked but there is none Assistant and the doctor work as a two-person rescue team. continuing to perform CPR at a ratio of 15:2 Position the patient supine Breathing is assessed The other assistant returns with the emergency drug kit. and the patient is ventilated with positive pressure oxygen. .” The airway is checked by using a Head Lift/ Chin Tilt. “shake and shout. and the AED. The AED is placed by the patient’s left shoulder and turned on. the oxygen cylinder. Cardiac Arrest Management Paramedics should transport the patient to the hospital for further treatment. The oxygen cylinder is turned on.

CPR .