RAJ K KHANNA DMD MD MUSOM NOTE THESE HANDOUTS ARE NOT TO BE USED WITHOUT CONTENT OF FULL COURSE MATERIALS and NOT INTENDED FOR REFERENCE WITHOUT ATTENDING COURSE IN PERSON ASSESSING FUNCTIONAL CAPACITY METs ID: 934363
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MEDICAL EMERGENCIES HANDOUTS
RAJ K KHANNA DMD, MDMUSOM
NOTE: THESE HANDOUTS ARE NOT TO BE USED WITHOUT CONTENT OF FULL COURSE MATERIALS and NOT INTENDED FOR REFERENCE WITHOUT ATTENDING COURSE IN PERSON
Slide2ASSESSING FUNCTIONAL CAPACITY – METs
Slide3NO SPECIAL
PRECAUTIONS
ELECTIVE CARE OK CONSIDER TREATMENT MODIFICATION
Slide4ELECTIVE CARE OK SERIOUS CONSIDERATION TO TREATMENT MODIFICATION
ELECTIVE CARE CONTRAINDICATED EMERGENCY TREATMENT ONLY IN CONTROLLED ENVIRONMENT
Slide54
MEMBER
TEAM
APPROACH
STAYS CALM !
Slide6EMERGENCY DRUGS AND EQUIPMENT
GLUCAGON
ATROPINE
Slide7SUGGESTED BASIC EMERGENCY DRUGS FOR THE GENERAL DENTAL OFFICE
Slide8RECOGNIZE PROBLEM
(lack of response to sensory stimulation)
DISCONTINUE DENTAL TREATMENTACTIVATE OFFICE EMERGENCY PLAN
P – POSITION PATIENT IN SUPINE POSITION WITH FEET ELEVATED
A B C
ASSESS
BREATHING, PALPATE CAROTID PULSE, PROVIDE
CIRCULATION IF NECESSARY THROUGH CHEST COMPRESSIONS
ACTIVATE EMS IF RECOVERY NOT IMMEDIATE
D PROVIDE DEFINITIVE CARE
LOSS OF CONSCIOUSNESS
Slide9RECOGNIZE PROBLEM
(lack of response to sensory stimulation)
DISCONTINUE DENTAL TREATMENT
ACTIVATE OFFICE EMERGENCY PLAN
P
– POSITION PATIENT IN SUPINE POSITION WITH FEET ELEVATED (
Trendelenberg
position)
C > A > B ASSESS CIRCULATION,
ASSESS/AND
OPEN AIRWAY ,
ASSESS
AIRWAY PATENCY AND BREATHING
D
DEFINITIVE CARE (OXYGEN, COLD TOWEL COMPRESSES, AMMONIA,GLUCOSE,VITAL SIGNS)ADMINISTER
ATROPINE IF BRADYCARDIA PERSISTSPOST SYNCOPIAL RECOVERY DELAYED RECOVER POSTPONE FURTHER DENTAL TREATMENT ACTIVATE EMS
VASODEPRESSOR SYNCOPE - MANAGEMENT
Slide10ASSESS
CONSCIOUSNESS
ACTIVATE OFFICE EMERGENCY SYSTEMP – POSITION PATIENT SUPINE WITH FEET ELEVATED
C A B - ASSESS CIRCULATION,
ASSESS/AND
OPEN AIRWAY,
ASSESS
BREATHING
D – DEFINITIVE CARE (OXYGEN,MONITOR VITAL SIGNS)
PATIENT RECOVERS DELAYED RECOVERY
slowly reposition chair
MONITOR PATIENT ACTIVATE EMS
DISCHARGE PATIENT CONTINUE BLS AS NEEDED
POSTURAL HYPOTENSION
MANAGEMENT
Slide11RECOGNIZE PROBLEM
PLACE PATIENT IN UPRIGHT OR SEMIRECLINED POSITION
REMOVE ANY DENTAL MATERIALS FROM PATIENTS MOUTH
INSTRUCT PATIENT TO TAKE IN SHALLOW BREATHS AND HOLD AS LONG AS POSSIBLE
REPEAT THIS 6-10 TIMES
ALTERNATIVELY HAVE PATIENT REBREATHE EXPIRED AIR FROM A BAG
DO NOT ADMINISTER OXYGEN
PATIENT RESPONSIVE(breathing normal) PATIENT UNRESPONSIVE
CONTINUE TREATMETNT OR DISCHARGE ACTIVATE EMS AND BLS AS NEEDED
HYPERVENTILATION
Slide12MILD
SEVERE DISCONTINUE TREATMENT
UPRIGHT POSITION
CALM PATIENT
ABCD
ADMINSTER OXYGEN
ADMINSTER BRONCHODILATOR
(
2-4 puffs initially repeat in 15 minutes
)
IMPROVEMENT NO IMPROVEMENT
DISCHARGE/CONTINUE APPT ACTIVATE EMS
CONTINUE BLS
EPNEPHRINE .5 TO .1MG SOL SC
repeat 10-20 mins if needed CONINTUE WITH BLSAMINPHYLINNE 50 MG IV UPTO 250 MG IV, DECADRON 10MG IV
ASTHMA MANAGEMENT
Slide13RECOGNIZE PROBLEM
(ITCHING, HIVES,EDEMA,FLUSHED SKIN
)DISCONTINUE DENTAL TREATMENT STOP EXPOSURE
ACTIVATE OFFICE EMERGENCY PLAN
C > A > B ASSESS AND PERFORM BLS AS NEEDED
PROVIDE DEFINITE TREATMENT AS NEEDED
MILD SEVERE
no
cvs
/respiratory involvement (
cvs
/respiratory involvement)
stridor ,wheezing, hypotension
OBSERVE SUMMON EMS
POSITION PATIENT
OXYGEN OXYGEN HISTAMINE BLOCKER HISTAMINE BLOCKER IM diphenhydramine 25-50mg im
diphenhydramine 25-50mg im BRONCHODILATOR BRONCHODILATOR
EPINEPHRINE .3MG ADULT SC, .15MG PEDIATRIC SC REPEAT IN 5-10 MINUTES IF NO IMPROVEMENT DISCHARGE PATIENT CONTINUE BLS/EMT
Slide14ANGINA MANAGEMENT
TERMINATE TREATMENT
POSITION PATIENT COMFORTABLY LOOSEN CLOTHING
A B C
DEFINITIVE MANAGEMENT
OXYGEN/MONITOR AND RECORD VITAL SIGNS CONTINOUSLY
HISTORY OF ANGINA NO HISTORY OF ANGINA
VASODILATOR .4MG NTG SUBLINGUAL IF NO PAIN RELIEF ACTIVATE EMS STAT
IF NO RELIEF IN 5 MINUTES REPEAT NTG ACTIVATE EMS CONSIDER NITROGLYCERIN
IF NO RELIEF IN 10 MINUTES REPEAT NTG ADMINSTER ASPRIN ADMINSTER ASPIRIN
IF PAIN RELIEVED DISCHARGE/ PCP CONSULT CONTINUE BLS CONTINUE BLS
Slide15TERMINATE TREATMENT
PLACE PATIENT IN UPRIGHT/ SEMI-RECLINED POSITION
ACTIVATE EMS
ESTABLISH AND MAINTAIN AIRWAY
ADMINISTER 100% OXYGEN
SET UP AUTOMATED EXTERNAL DEFIBRILLATION
BE READY FOR BLS
ADMINISTER NON-ENTERIC COATED ASPIRIN 325MG (CHEWABLE)
NITROGLYCERIN –0.2-0.6 MG SUBLINGUALLY – REPEAT EVERY 5 MINUTES UP TO 3 DOSES OVER 15 MINUTES
MONITOR VITAL SIGNS / EKG
REASSURE PATIENT
ESTABLISH I.V. ACCESS
START BLS IF PATIENT LOSES CONSCIOUSNESS TRANSPORT PATIENT TO HOSPITAL
MYOCARDIAL INFARCTION MANAGEMENT