Basic Guide to Medical Emergencies in the Dental Practice

The Basic Guide to Medical Emergencies in the Dental Practice is a must have book for all dental care professionals.

Written in a clear and accessible style, chapters cover such key topics as patient assessment, adult resuscitation, respiratory and cardiac disorders, paediatric emergencies, emergency equipment, and law and ethics.

Illustrated in full colour throughout

Follows Resuscitation Council (UK) guidelines

Accessible, full colour guide

Handy format for easy reference and portability

Evidence-based

Table of Contents

Foreword Karen Elley ix

Acknowledgements x

1 Medical emergencies and resuscitation in the dental practice: an overview 1

Introduction 1

Concept of the chain of survival 2

Incidence of medical emergencies in dental practice 3

General Dental Council guidelines on medical emergencies 5

Resuscitation Council (UK) statement 5

ABCDE assessment of the sick patient 7

Medical risk assessment in general dental practice 8

Principles of safer handling during cardiopulmonary resuscitation 10

Procedure for calling 999 for an ambulance 11

Conclusion 13

References 13

2 Resuscitation equipment in the dental practice 15

Introduction 15

Recommended minimum resuscitation equipment in the dental practice 16

Checking resuscitation equipment and drugs 20

Checking resuscitation equipment following use 22

Conclusion 23

References 23

3 Recognition of the sick patient: the ABCDE approach 24

Introduction 24

Clinical signs of acute illness 24

The ABCDE approach 25

General principles of the ABCDE approach 26

The ABCDE approach to the sick patient 27

Principles of pulse oximetry 32

Procedure for administering oxygen to the acutely ill patient 37

Procedure for recording blood pressure 40

Conclusion 44

References 44

4 Respiratory disorders 46

Introduction 46

Management of acute asthma attack 47

Management of hyperventilation 53

Management of exacerbation of chronic obstructive pulmonary disease 54

Procedure for using an inhaler 55

Procedure for using a spacer device 59

Conclusion 62

References 62

5 Cardiac disorders 64

Introduction 64

Management of angina 64

Management of myocardial infarction 66

Management of palpitations 70

Management of syncope 72

Conclusion 74

References 74

6 Neurological disorders 76

Introduction 76

Management of a generalised tonic-clonic seizure 76

Management of stroke 81

Management of altered level of consciousness 84

Procedure for placing a patient in the recovery position 85

Spinal injury 90

Conclusion 90

References 90

7 Endocrine disorders 92

Introduction 92

Management of hypoglycaemia 92

Procedure for blood glucose measurement using a glucometer 98

Management of adrenal insufficiency 99

Conclusion 101

References 101

8 Anaphylaxis 103

Introduction 103

Definition 104

Incidence 104

Pathophysiology 105

Causes 105

Clinical features and diagnosis 105

Treatment 107

Conclusion 111

References 112

9 Cardiopulmonary resuscitation in the dental practice 114

Introduction 114

Resuscitation Council (UK) automated external defibrillation algorithm 115

Procedure for cardiopulmonary resuscitation in the dental chair 115

Procedure for performing chest compressions 123

Conclusion 126

References 126

10 Airway management and ventilation 128

Introduction 128

Causes of airway obstruction 129

Recognition of airway obstruction 129

Simple techniques to open and clear the airway 130

Use of oropharyngeal airway 133

Principles of ventilation 136

Treatment of foreign body airway obstruction 145

Conclusion 148

References 148

11 Automated external defibrillation 150

Introduction 150

Ventricular fibrillation 151

Physiology of defibrillation 151

Factors affecting successful defibrillation 152

Safety issues and defibrillation 153

Procedure for automated external defibrillation 153

Conclusion 156

References 156

12 Paediatric emergencies 158

Introduction 158

ABCDE assessment of a sick child 159

Principles of paediatric resuscitation 161

Placing a child into the recovery position 168

Management of foreign body airway obstruction 169

Conclusion 172

References 172

13 Professional and legal issues 174

Introduction 174

The scope of a dental professional's accountability 175

Legal requirements for consent and acting in a patient's best interests 186

Duty of confidence owed to patients by dental professionals 194

Conclusion 200

References 201

Index 203