Emergencies in

dental clinic

BY DR.FAHAD ALI
2 CARDIOPULMONARY
RESUSCITATION
• All dental staff must be certified in CPR
• Phone first and phone fast
• Certify every two years
3 THE ABCS OF CPR

• Airway
• Breathing
• Circulation
• Defibrillation
 4
FOREIGN BODY AIRWAY OBSTRUCTIONS

• FBAO during treatment

• Dental materials fall into throat

• Common problematic materials

• Crowns
• Cotton rolls
• Gauze
5
TREATMENT OF OBSTRUCTION
IN THE CONSCIOUS PATIENT

• Stop treatment
• Sit patient upright
• Encourage patient to cough
• Perform Heimlich maneuver if necessary
6
Heimlich Maneuver
in the Conscious Adult
7
Heimlich Maneuver
in the Conscious Adult
 8 TREATMENT OF OBSTRUCTION
IN THE UNCONSCIOUS PATIENT

• Lay patient on floor

• Perform finger sweep
• Give two rescue breaths

• If airway is still obstructed

• Reposition patient
• Perform chest thrusts
9
TREATMENT OF
UNCONSCIOUS ADULT WITH FBAO
10
COMMON
EMERGENCIES IN A DENTAL OFFICE

• Syncope
• Asthma
• Orthostatic Hypertension
• Allergic reaction
• Anaphylactic reaction
11
COMMON
EMERGENCIES IN A DENTAL OFFICE

• Hyperventilation
• Seizures
• Diabetic emergencies
• Hypoglycemia
• Insulin shock
• Cardiovascular emergencies
12 SYNCOPE

• Fainting
• Decreased blood flow to brain
• Lying still for prolonged periods
• Stress
• Emotional or physical
13 SYMPTOMS OF SYNCOPE

• Dizziness
• Nausea
• Weakness
• Pale and clammy skin
• Shallow breathing
 14
TREATMENT FOR SYNCOPE
IN THE CONSCIOUS PATIENT

• Place patient in sitting position

• Have patient place head between knees
15
TREATMENT FOR SYNCOPE
IN THE UNCONSCIOUS PATIENT

• Place patient in Trendelenburg position

• Loosen clothing or jewelry
• Administer oxygen
• Administer spirit of ammonia under nose
16 DRUGS IN EMERGENCY KIT

• Spirits of ammonia
• Ammonia inhalants
• Glass tube covered with gauze
• Broken under patient’s nose
• Used to treat syncope
17
TRENDELENBURG POSITION
18 ASTHMA

• Recurrent episodes of breathlessness accompanied by

wheezing
• Narrowing of airways due to stimulus
19 TREATMENT OF ASTHMA

• Administer inhaler
• Administer oxygen
• Calm patient
 20

• Bronchodilator
• Albuterol (inhaler)
• Improves air flow
• Does not stimulate cardiovascular system
 21

• Bronchodilator
• Patient exhales
• Breathes in while dispensing drug
• Repeat
• Within 15 minutes
• Breathing improves
• If no improvement
• Call 9-1-1, give oxygen
22 ORTHOSTATIC HYPERTENSION

• Lose of consciousness or a level of consciousness when

sitting upright quickly
23 ANAPHYLACTIC REACTION

• Severe, life-threatening allergic reaction

• Body creates large amount of histamine
• Tongue and throat swell
• Causes include:
• Bee stings
• Penicillin
• Anesthetics
24
ANAPHYLACTIC
SIGNS AND SYMPTOMS

• Loss of consciousness
• Skin rash
• Drop in blood pressure
• Nausea and vomiting
• Shortness in breath
• Tongue and throat swell
25 TREATMENT OF ANAPHYLAXIS

• Epinephrine
26 HYPERVENTILATION

• Causes
• Deep and rapid breathing
• Loss of carbon dioxide in blood

• Symptoms
• Faintness
• Numbness
27 HYPERVENTILATION

• Treatment
• Sit patient upright
• Have him or her breathe into a paper bag
28 EPILEPSY/SEIZURE DISORDER

• Unorganized charges in the brain causing a change in

consciousness
• May be minimal to severe
• Grand mal, petit mal, partial seizures
29
TREATMENT OF
AN EPILEPTIC SEIZURE

• Remove dental materials from the patient’s mouth

• Remove glasses and loosen clothing
• Do not restrain the patient
30

• Anticonvulsants
• Diazepam (valium)
• Injection form
• Controls seizures
• Valium may be given as a premed in tablet form to manage stress
31 POSTSEIZURE

• Place patient in recovery position

• Reassure patient
• Let patient recover
• Patient may:
• Be disoriented and exhausted
• Not remember seizure
• Lose control of bladder or bowel
32 TYPE I DIABETES:
JUVENILE DIABETES

• Affects mostly ages 10 to 16 years

• Associated most often with additional medical problems
• Usually requires daily insulin injections
• Comprises 10 percent of diabetes cases
• Most severe form of disease
 33 TYPE II DIABETES:
ADULT ONSET

• Usually controlled with diet and/or hypoglycemics

• Does not require insulin injections
• Seen most often in:
• Obese adults
• Adults over age 40
34
HYPERGLYCEMIA:
HIGH BLOOD SUGAR LEVELS

• Patient has eaten but not taken insulin

• Too much sugar (glucose) in blood
• Not enough insulin
35 SIGNS OF HYPERGLYCEMIA

• Increased thirst; dry mouth

• Excessive urination
• Acetone breath
• Blurred vision
• Rapid pulse
• Lower blood pressure
• Loss of consciousness
36
TREATMENT OF HYPERGLYCEMIA:
DIABETIC KETOACIDOSIS OR COMA

• Conscious
• Patient administers own insulin if available

• Unconscious
• Provide basic life support
• Transport to medical facility
37

• Antihypoglycemic
• Management of hypoglycemia
• Tube of cake icing
• Orange juice
• Cola syrup
• Sugar packets
38
HYPOGLYCEMIA:
LOW BLOOD SUGAR

• Causes
• Overexertion
• Emotional stress
• Missing meals
• Overdose of insulin
• Excessive exercising
39
SIGNS AND SYMPTOMS OF
HYPOGLYCEMIA (INSULIN SHOCK)
• Cold sweat
• Nervousness
• Trembling
• Weakness
• Hunger
• Personality change
• Confusion
40 TREATMENT OF HYPOGLYCEMIA

• Conscious
• Administer sugar source

• Unconscious
• Give injection of glucagon
• Administer sugar source under tongue or buccal fold
41 ANGINA

• Pain in chest area, neck, and jaw

• Five-minute duration
• Increased blood pressure and pulse
• Pale and clammy skin
• Administration of nitroglycerin
• Dilates coronary arteries
• Heart receives oxygen
42

• Nitroglycerin
• Management of chest pain
• Vasodilator
• Route of administration
• Translingual
• Sublingual
• Transdermal patch
43
MYOCARDIAL INFARCTION: HEART
•
ATTACK
Caused by blocked or narrowed arteries
• Symptoms similar to angina but not relieved with nitroglycerin
• One third of heart attack victims die
• Heart tissue dies
44 TREATMENT OF
MYOCARDIAL INFARCTION

• Position patient comfortably

• Administer oxygen
• Administer nitroglycerin
• Administer 160–325 mg chewable aspirin
45 CONGESTIVE HEART FAILURE

• Inability of heart to pump

• Fluid collects around ankles and legs
• Heart progressively weakens
• Administer diuretics
46 STROKE/CVA

• Leading cause of death and disability in the United States

• Sudden in onset
• Caused by interruption of the blood supply to brain

• Administer oxygen and call for EMS