Medical Urgencies and Emergencies Donald Falace, DMD Oral Diagnosis and Oral Medicine UK College of Dentistry
Jan 17, 2016
Medical Urgencies and Emergencies
Donald Falace, DMD
Oral Diagnosis and Oral Medicine
UK College of Dentistry
Goals
Develop a sense of vigilance and anticipation
Enable you to respond to an urgent medical need in a reasonably confident and efficient fashion
Urgencies vs. Emergencies Urgency: a problem that requires prompt response; it is not
immediately life threatening but could become so if not resolved promptly Syncope Hypoglycemia Seizure Asthmatic attack Hyperventilation Angina Mild allergic reaction Stroke
Emergency: a problem that is immediately life threatening and requires immediate action Cardiac arrest Anaphylaxis Obstructed airway
Be observant!
Look at and listen to your patient Watch for changes in:
Speech (slurring, halting, excessively talkative, silent)
Behavior (becomes quiet, restless, agitated, anxious, fearful, uncomfortable, nauseated, has difficulty breathing, non-communicative)
Appearance (pale, ashen, flushed, sweating, trembling)
Anticipation, Prevention and Planning
Anticipation: What type of urgency/emergency can you anticipate with this patient?
Prevention: What can you do to decrease the risk of occurrence?
Planning: What would you do if the problem does occur?
Reality Check
It is estimated that about 90% of urgencies - emergencies can be prevented.
This means that 10% will occur in spite of our best efforts
UKCD Urgency/Emergency Response Protocol in Clinic
Attend to the patient If conscious, allow patient to assume a comfortable
position, monitor vital signs, give oxygen as needed, try to determine what the problem is
If unconscious, PABCD Stay with the patient Call for help from your supervising faculty member (or
any faculty member) If not immediately life-threatening and additional help is
needed, call Oral Surgery 3-5279 If cardiac arrest or anaphylaxis, call 3-5200 and report
“code 500” and give location and nature of the problem
Location of Emergency Equipment
Medical Emergencies Equipment in the Clinic
Oxygen tank, ambu bag, tubing and mask
Automated blood pressure cuff and pulse oximeter
Drug box Defibrillator
Drug Box Albuterol inhaler Ammonia ampules Aspirin Diphenhydramine (oral;
injectable) Epinephrine (EpiPen;
ampules) Glucose Nitroglycerine (spray;
tablets) Ephedrine (hypotension) Solucortef (adrenal crisis) Narcan (narcotic overdose) Atropine (bradycardia)
Defibrillator
Located in COD on 2nd, 3rd and 5th floors
Phone
Oral Surgery 3-5749
Cardiac Arrest or Anaphylaxis 3-5200 and report
“code 500” Outside of Medical
Center - 911
Emergency Medicine in DentistryStanley Malamed, DDS
Disk 1: Preparation for
emergencies Emergency drug kit Basic management
protocol
Disk 2: Altered consciousness Respiratory distress Allergic response Cardiovascular problems