DH 206 Module 8: Dental Office Medical Emergencies Study Guide

Practice flashcards based on the DH 206 Module 8 Study Guide covering medical emergencies, emergency drugs, and clinical management in the dental office.

What factors contribute to the increase in medical emergencies in the dental office?

Contributing factors include the increasing age of the population, advances in medical science allowing medically compromised patients to receive dental care, longer treatment appointments, and the increased use of drugs in dentistry.

What are the essential components of emergency preparedness?

Key components include a maintained emergency kit, necessary equipment such as oxygen tanks, a clear manual of emergency protocols, and a dental team that undergoes regular training and drills.

In order, what are the steps represented by the acronym CAB in basic life support?

$1$. Circulation (Chest Compressions), $2$. Airway, and $3$. Breathing.

What is the first position for a patient who faints (syncope)?

The patient should be placed in the Trendelenburg position (supine with the feet slightly elevated above the head).

What are the common signs of hypoglycemia?

Signs include sweating (diaphoresis), shakiness, confusion, tachycardia, and cold, clammy skin.

What is the identified treatment for a diabetic coma (hyperglycemia)?

Diabetic coma requires immediate activation of emergency medical services (EMS), administration of fluids, and professional insulin therapy in a hospital setting.

How should a patient having a seizure be managed?

Place the patient in a supine position (in the dental chair or on the floor), clear the area of hazards to prevent injury, maintain the airway, and do not restrain the patient or place objects in their mouth.

What is the primary treatment for hyperventilation?

The primary treatment is to calm the patient and have them breathe into their own cupped hands to re-breathe carbon dioxide; oxygen should NOT be administered.

What is the first-line treatment for managing an acute asthma attack?

Albuterol (a short-acting beta-$2$ agonist bronchodilator).

What is the drug of choice for treating anaphylaxis?

Epinephrine.

Compare the management of a conscious versus an unconscious patient with airway obstruction.

For a conscious patient, perform abdominal thrusts (Heimlich maneuver). For an unconscious patient, place them in a supine position and begin chest compressions.

What are the rules for using Nitroglycerin regarding repetition and contraindications?

Administer one tablet or spray every $5\,minutes$ up to a maximum of $3$ doses; it must not be given if the patient’s systolic blood pressure is below $90\,mmHg$ or if the patient has used PDE5 inhibitors (erectile dysfunction medications) within the last $24$ to $48\,hours$.

What are the signs and symptoms of a myocardial infarction (MI)?

Signs include crushing chest pain, pain radiating to the left arm or mandible, nausea, vomiting, and shortness of breath.

What is the immediate first step in cardiac arrest management?

The immediate first step is to call for Emergency Medical Services (EMS) and begin high-quality CPR starting with chest compressions.

Which cardiovascular emergencies are commonly identified in dental settings?

Common emergencies include angina pectoris, myocardial infarction (MI), cardiac arrest, cerebrovascular accident (stroke), and acute hypertensive crisis.

What drug is used for treating extrapyramidal reactions?

Diphenhydramine (Benadryl).

What are the steps to treat an adrenal crisis and which drug is used?

Steps include positioning the patient supine, activating EMS, and administering the drug of choice, which is hydrocortisone (Solu-Cortef).

Which medication should be avoided during a thyroid storm?

Epinephrine (and other sympathomimetic drugs) must be avoided.

What is the drug of choice for malignant hyperthermia?

Dantrolene.

Which medication is used to treat an opioid overdose?

Naloxone (Narcan).

What are the signs of local anesthetic toxicity?

Initial CNS excitation (restlessness, talkativeness, twitching) followed by CNS depression (slurred speech, drowsiness, and potential seizure or respiratory arrest).

How is an epinephrine reaction managed?

Terminate the procedure, position the patient upright, monitor vital signs, and provide reassurance until the symptoms (anxiety, palpitations) pass.

What are Level 1 (critical) drugs and their primary uses?

Level 1 drugs include Epinephrine (anaphylaxis), Diphenhydramine (allergy), Oxygen (respiratory distress), Nitroglycerin (angina), Albuterol (asthma), Glucose (hypoglycemia), and Aspirin (MI).

Which local anesthetic is preferred for use in pregnancy?

Lidocaine (Category B) is typically preferred.

What are appropriate actions when treating a substance abuse patient?

Actions include consulting with the patient's physician, avoiding mind-altering substances (like nitrous oxide), and limiting or avoiding epinephrine if active stimulant use is suspected.