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Emergency in dental office are usually rare encounters since the practioners potential
problems and manage them before because of an emergency.
Incidence of a medical emergency is seen mostly during or before a surgical care because
of three factors namely ;
Medical evaluation(history)
Physical examination
Step Two: Prevention is the best thing after prevention, deal with the management
of medical emergency.
Make patient lie down supine position with head low and tilted to one side
Other factors be anxiety ,fear, sight of blood , pain, extortion, fasting and hot
environment
If treatment is not instituted patient develops unconsciousness, ashen grey color of skin,
shallow respiration, decreased blood pressure weak pulse ,standing patient falls; may
develop clonic jerks and twitching of facial muscles.
Management
If absent
If present
Phenylephrine/methoxamine
2. SHOCK
Prime Shock is also called syncope which is not tackled and if persists then secondary
appears.
Seen on account of :
1. Haemorrhagic shock – due to massive loss of internal bleeding.
2. Hypovolumic Shock – due to fluid loss
Disparity between the circulating blood volume of the body and the volume capacity of
the vascular tree
• Unconsciousness
• Ashen grey face
• Cold Clamming skin
• Lips, nails, lobule of ear – grayish blue
• Face expression – sunken eyes
• Pupils decaled
• Weak pulse
• Respiration shallow ,irregular ,rapid
• Temperature – subnormal
• Shock can be more easily prevented then treated.
Allergic Reaction
Allergy/hypersensitivity is an unwanted response of the body to a complete dose of the
drug. It is as a result if an immunological response by the individual who has become
sensitized to the drug through a prior exposure.
Allergic reaction affecting the resp track are more serious.They manifest as angioedema
of tongue,eyelids,larynx and bronchi. In case of more severe reaction,patient may
complain of dyspnoea,wheezing,bronchospasm and many become cyanotic. Patients
unable to speak produces stridors.
Treatment
Respiratory Emergencies
1. Hyperventilation
Reactions
Manifestation
Management
Manifestation
Management
Management
Manifestation
Management
Manifestation
Management
Siezures
Management – Terminate Dent. Procedure
Patient Position – supine with legs elevated medical assistance protect patient from
injury basic life support oxygen monitor vital signs
Children – 0-3mg/kg
Unconscious Patient
Patient Position – horizontal supine rain-heart same level feet elevated 10-15
degrees head down
Pregnant – on right
Adrenal Insufficiency
Patient who are on long term contrcosleroids for reaction of a variely of syscenue cored
develop adrenal suppression
If any patient is under stress the adrenal suppression prevents the normal release of
glucocorticoids from the adrenal cortex. This is because of fall in production of ACTM
secreted by anterior in response to the steroids ademin to the patient to the point . ACTM
in turn controls the production of corticoids in the adrenal cortex.
Management
Pregnancy
A resp to em and pl___ stress of Px large quantity of steroids are liberated into the
blood stream .It secretes oxcylocim and lead to premature labour
Turning patient onto the side will relieve the patient pressure and put the back to
the normal.
Asllrune
Patient with H/O assllrune can be particularly challenge to manage safely.It may
trigger due to em. Stress or any pharma agents.The signal of onset is
Bronchospasm
Patient complains of :
o Shortness of breadth
o Sit erect(patients wants to)
o Wheezing in audible
o tachypnea
hypoxic
Management
o terminate treatment
o repos- patients in sitting posture
o admin broncho_____ (___)
o admin oxygen
o monitor vital stats
if symptoms continue :
ep____ - 0.3ml
1:10000
1m SC 1v
1/vdring crystalloid
solution
If vital signs reduce
then refer physician
If symptoms correct
medical assistment
theoplylin 1/v 250mg &
corlisone 100mg 1/v
emergency
Chest Discomfort
The app of chest discomfort is a patient who ___ __ is chaemic heart disease in the peri
uperentive period caleis
Clinical Features
Treatment
Admin oxygen
If:
Continuous(3mins) 2nd dose TNG,moniter vital stats if not relieved, 3rd dose
,moniter vital stats if not relieved discomfort continuous then :
1. assume MI in
progress
2. S_____ medical
assistance
3. 1/v drip crystalloid
sol. 30min/hr
4. Morphine Sulfate
5. Transport for
Emmergency
Diabetes
Manifestation
Management
G or 1mg