Lecture 3 key points

What is the most common emergency in the dental office?

Loss of consciousness due to fainting

What are predisposing factors that increase a patient's risk of losing consciousness?

Physiological or psychological stress, underlying health problem, and administration of drugs such as opioids or local anesthesia.

What is orthostatic hypotension?

A drop in blood pressure that occurs when standing or sitting up after laying down

What is another name for orthostatic hypotension?

Postural hypotension

What treatment modifications should be made for a patient with known orthostatic hypotension?

Frequent breaks, avoid keeping the patient prone for long time, raise the dental chair incrementally over time, and sit upright for a few minutes before standing.

How should the dental chair be raised for a patient with orthostatic hypotension?

Incrementally over a period of time

What should a patient with orthostatic hypotension do before standing up from the dental chair?

Sit upright in the dental chair for a few minutes before attempting to stand.

What is presyncope?

stage before a patient falls unconscious.

What are common symptoms of presyncope?

Warmth in the head and neck, lightheadedness, and nausea.

What should you do as soon as fainting is suspected?

Lay the patient back in the dental chair in a SUPINE position with the legs elevated.

Which artery is preferred for checking a patient's pulse in an emergency?

carotid artery

Where is the carotid artery palpated?

On the side of the neck between the tracheal cartilage and sternocleidomastoid muscle

What chain of events leads to fainting?

A stimulus such as fear causes a release of catecholamines into the blood, which causes a DROP in blood pressure and a DECREASE in blood perfusion to the brain.

What happens to blood pressure during the chain of events that causes fainting?

Blood pressure DROPS

What happens to blood perfusion to the brain during fainting?

It DECREASES

When should EMS be contacted for an unconscious patient?

If the patient does not regain consciousness after a few seconds of being tipped back in the dental chair

How long should dental treatment be postponed after a patient loses consciousness?

At least 24 hours.

Why should dental treatment be postponed for at least 24 hours after a patient loses consciousness?

The patient is at risk for another syncopal episode.