Term
| What are some factors that may increase the chances of a medical emergency in a dental office? |
|
Definition
-older patients
-therapeutic advances in medicine
-longer dental appointments
-increase use of drugs |
|
|
Term
| What are some factors to help decreases the chances of a life threatening emergency? |
|
Definition
-pretreatment physical evaluation
-medical history questionnaire
-dialogue history
-physical exam
-modifications in dental care |
|
|
Term
| What are the top 8 medical emergencies in dental offices? |
|
Definition
1.syncope
2.mild allergic reaction
3.angina pectoris
4.postural hypotension
5.seizures
6.bronchospasm
7.hyperventilation
8.epinephrine reaction |
|
|
Term
|
Definition
|
|
Term
| What is postural hypotension? |
|
Definition
| low blood pressure when patient stands up |
|
|
Term
| What are these emergencies mostly induced by? |
|
Definition
|
|
Term
| What are some medical emergencies that are stress induced? (5) |
|
Definition
1.vasopressor syncope
2.hyperventilation
3.acute cardiovscular eemergencies
4.bronchospasm
5.seizure |
|
|
Term
| What are some drug-related adverse reacions to local anesthestics? |
|
Definition
1.psychogenic(stress related)
2.overdose
3.allergy |
|
|
Term
| What are allergic reactions in local anesthesia usually caused by? |
|
Definition
| reactions to preservatives in anesthesia |
|
|
Term
| Do most of these emergencies int he dental office lead to death? Can they? |
|
Definition
| they can, but it is rare that a patient actually dies |
|
|
Term
| What is the statistic reported by the ADA about deaths in dental offices? |
|
Definition
| out of 4000 dentists surveyed there were 45 deaths reported |
|
|
Term
| How long does oxygen last in a E cylinder? |
|
Definition
|
|
Term
| 90% of all lie threatening emergencies can be prevented with what? |
|
Definition
| an appropriate physical exam |
|
|
Term
| How many sudden unexpected deaths occur in spite of preventative measures? |
|
Definition
| 10%,the other 90% are prevented |
|
|
Term
| What are three important aspects of prevention? |
|
Definition
1.medical history questionnaire
2.physical exam
3.dialogue history |
|
|
Term
| How often does a medical history questionnaire need to be updated? |
|
Definition
|
|
Term
| Why do we do a medical history questionnaire? |
|
Definition
| because it is morally and legally necessary in the practice of medicine and dentistry |
|
|
Term
| What information does the medical history questionnaire provide? |
|
Definition
| valuable information about physical and psychological condition of the patient |
|
|
Term
| What are the three things recorded in a minimal physical exam? |
|
Definition
1.vitals
2.visual inspection of patient
3.height, weight, age |
|
|
Term
| What are the things recorded in vitals? (extensive) |
|
Definition
1.blood pressure
2.heart rate(pulse) and rhythm
3.respiratory rate
4.temperature
5.height
6.weight |
|
|
Term
| How much of the arm should a bloodpressure bladder cover? |
|
Definition
|
|
Term
| A loose blood pressure cuff could cause a false BLANK. |
|
Definition
|
|
Term
| What is the blood pressure seen in ASA I? |
|
Definition
|
|
Term
| What do we do for and ASA class I? |
|
Definition
| no precautions, recheck in 6 months |
|
|
Term
| What are the blood pressures seen in ASA class II? |
|
Definition
|
|
Term
| What do we do for an ASA class II? |
|
Definition
-recheck before treatment for 3 consequtive appointments
-observe
-implement stress reduction protocol |
|
|
Term
| What are the blood pressures for ASA class III? |
|
Definition
|
|
Term
| What are the dental considerations for ASA class III? |
|
Definition
-recheck in 5 mins
-med con
-implement stress reduction |
|
|
Term
| What is the blood pressure at which we dismiss patients? |
|
Definition
|
|
Term
| What are some signs of anxiety in the reception room? |
|
Definition
-clinical signs
-questions to receptionist about injections
-nervous conversations with other patients
-history of emergency dental care
-cold, sweaty palms |
|
|
Term
| What are some signs of anxiety in the dental chair? |
|
Definition
-stiff
-nervous movement
-white knuckles
-perspiration
-overwillingness to cooperate
-quick answers |
|
|
Term
| What is the physical status classification of a person that is ASA Class I? |
|
Definition
| normal, healthy patient without systemic conditions |
|
|
Term
| What is the physical status classification of a person that is ASA Class II? |
|
Definition
| patient with mild systemic disease(controlled diabetes) |
|
|
Term
| Who is automatically considered an ASA class II? |
|
Definition
|
|
Term
| What is the physical status classification of a person that is ASA Class III? |
|
Definition
| patient with severe systemic disease that limits activity but is not incapasitating |
|
|
Term
| What are some examples of conditions seen in ASA class III? |
|
Definition
|
|
Term
| What is the physical status classification of a person that is ASA Class IV? |
|
Definition
| a patient with an incapacitating systemic disease that is a constant threat to life |
|
|
Term
| What is an example of a person that is ASA class IV? |
|
Definition
|
|
Term
| What is the physical status classification of a person that is ASA Class V? |
|
Definition
| moribund patient not expected to survive 24 hours or without an operation |
|
|
Term
| What is the physical status classification of a person that is ASA Class E? |
|
Definition
| emergency operation of any variety |
|
|
Term
| What are the steps to determine if a patient needs a med con? |
|
Definition
-medical and dental history
-complete oral and general exam
-develop treatment plan
-choose ASA classification
-consult physician when appropriate |
|
|
Term
| What do we need to do to document our conversations with our patients? |
|
Definition
| we need to write a complete report of our findings with our patients |
|
|
Term
| What are some stress reduction protocols? |
|
Definition
-reconize anxiety
-premedicate the evening before or right before treatment
-schedule appointment in morning
-minimize waiting time
-consider psychosedation
-administer adequate pain control |
|
|
Term
| What is is considered is one's pulse is <60 BPM? |
|
Definition
|
|
Term
| What is it called if a patient's pulse is above 100 BPM? |
|
Definition
|
|
Term
| What is the period of silence between beats went are listening to someone's blood pressure called? |
|
Definition
|
|
Term
| What is the normal respiration rate for an adult? Child? |
|
Definition
|
|
Term
| How often should we practice emergency drills? |
|
Definition
|
|
Term
| What are the steps to basic life support? |
|
Definition
Positioning
Circulation
Airway
Breathing
Definitive Treatment |
|
|
Term
|
Definition
| positioning-put patient flat on floor or put something under them to support them |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How many members should the emergency team consist of? |
|
Definition
|
|
Term
| What does the doctor usually do? |
|
Definition
| lead the team and directs other team members |
|
|
Term
| What are the duties of team member 1? |
|
Definition
-stay with victim
-alert office staff members-assign 2 team members
-evaluate vitals
-administer oxygen
-administer drugs(ONLY DENTIST)
-provide BLS |
|
|
Term
|
Definition
| basic life support(PCABD) |
|
|
Term
| WHat are the duties of team member 2? |
|
Definition
-bring emergency kit and oxygen to site
-check time
-prepare drugs as directed
-assist team leader |
|
|
Term
| What are the duties of team member 3? |
|
Definition
-assist with BLS
-monitor vitals
-prepare drugs
-call 911
-assist
-keep records
-meet rescue team at building entrance |
|
|
Term
| Who are we supposed to call in an emergency? |
|
Definition
-EMS 911
-DDS
-campus police |
|
|
Term
| When do we call for help? |
|
Definition
-as soon as leader deems it necessary
(never hesitate, the earlier the better) |
|
|
Term
| Is drug administration necessary for the immediate management of medical emergencies? |
|
Definition
|
|
Term
| What does primary management of emergency situations involve? |
|
Definition
|
|
Term
| When in doubt...DO or Never medicate? |
|
Definition
| when in doubt, NEVER medicate |
|
|
Term
| What are two drugs used in the management of an acute allergic reaction? |
|
Definition
-epinephrine
-histamine blockers(diphenhydramine or Benadryl) |
|
|
Term
| What is another name for histamine blockers? |
|
Definition
|
|
Term
| What are some drugs for bronchospasm? (asthma attack) |
|
Definition
-Epinephrine(inject)
-albuterol inhaler |
|
|
Term
|
Definition
|
|
Term
| What are vascodilators used for? |
|
Definition
|
|
Term
| What is an example of a vascodilator? |
|
Definition
| nitroglycerin/amyl nitrate |
|
|
Term
| What are two bronchodilators? |
|
Definition
|
|
Term
| What do you treat someone that is hypoglycemic with? |
|
Definition
| an antihypoglycemic food or drink like orange juice or cake icing |
|
|
Term
| What do you use to treat MI or angina? |
|
Definition
| aspirin(an anti-platelet drug) |
|
|
Term
| What can you use to treat fainting (syncope)? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| controls nausea and vomiting |
|
|
Term
|
Definition
|
|
Term
| What is ephedrine sulfate? |
|
Definition
|
|
Term
| What does atropine sulfate do? |
|
Definition
| dry secretions/opens airway |
|
|
Term
| What are corticosteriods(solu- cortef) used to treat? |
|
Definition
|
|
Term
| How many liters of oxygen are in an E cylinder? How long does it last? |
|
Definition
-650 liters
-lasts 30 mins |
|
|
Term
| What does the regulator do? |
|
Definition
| aloows pressure to be released at a reduced rate |
|
|
Term
| What does the flow meter do? |
|
Definition
| controls the amount of oxygen the patient is administered |
|
|
Term
| What are the parts of the oxygen delivery system suggested for an emergency kit? |
|
Definition
-e cylinder
-positive pressure mask
-bag-valve-mask device
-one pocket mask for each staff member |
|
|
Term
| What is some critical emergency equipment? |
|
Definition
-oxygen delivery system
-syringes
-suction and suction tips
-tourniquets
-magill intubation forceps |
|
|
Term
| How many liters per minute should the oxygen be set to with a face mask with reservoir? |
|
Definition
|
|
Term
| How much oxygen is 6-10 L/min? |
|
Definition
|
|
Term
| What is a nasal cannula designated for? |
|
Definition
| for lot consumption of oxygen |
|
|
Term
| What are the benefits of self-inflating valve mask? |
|
Definition
-immidiate ventilation
-increased oxygen to patient
-can be used with spontaneous breathing |
|
|
Term
| What size syringes are suggested for an emergency kit? |
|
Definition
| 2-4, 2 mL disposable syringes |
|
|
Term
| What gauge should the syringe needles be? |
|
Definition
|
|
Term
| How many tournquets are suggested for an emergency kit? What else is suggested? |
|
Definition
-3 tournequets
-a sphygmomanometer (blood pressure cuff) |
|
|
Term
| What are magill intubation forceps used for? |
|
Definition
| ideal for grapsing objects deep in te hypopharynx such as the endo thacheal tube |
|
|
Term
| How many magill intubation forceps are in each emergency kit? |
|
Definition
| one pediatric size in each kit |
|
|
Term
| What accounts for 50% of all emergency situations int he dentl office? |
|
Definition
|
|
Term
| What is the first step in treating an unconscious patient? |
|
Definition
-check response
-check senses
-mke sure they can breathe |
|
|
Term
| What is the 2nd step in treating an unconscious patient? |
|
Definition
| terminate the dental procedure |
|
|
Term
| What is the third step in treating an unconscious patient? |
|
Definition
|
|
Term
| What is the 4th step in treating an unconscious patient? |
|
Definition
| position victim in the supine position with the brain at the same level as the heart. |
|
|
Term
| what is step 5 in treating an unconscious patient? |
|
Definition
Assess and open airway
-head tilt technique
-jaw thrust technique
-head tilt chin lift technique |
|
|
Term
| what is step 6a in treating an unconscious patient? |
|
Definition
| Assess airway patency and breathing, the victim may be breathing spontaneously or inadequately or may not be breathing at all. |
|
|
Term
| what is the technique to tell if an unconscious patient is breathing? |
|
Definition
|
|
Term
| How is the look, listen and feel technique done? |
|
Definition
| while maintaining the head tilt, the rescuer assesses airway patency by placing their ear over the victims nose an mouth. |
|
|
Term
| what is step 6b in treating an unconscious patient? |
|
Definition
|
|
Term
| what are the types of artificial ventilation? (3 types) |
|
Definition
-exhaled air ventilation
-Atmospheric air ventilation
-Oxygen enriched ventilation |
|
|
Term
| what is step 7 in treating an unconscious patient? |
|
Definition
|
|
Term
| what is exhaled air ventilation? |
|
Definition
| mouth to mouth resuscitation is performed by the rescuer. |
|
|
Term
| what is Atmospheric Air ventilation? |
|
Definition
-the rescuer maintains head tilt and hold the face mask securely in place
-the victim's chest must rise with each compression of the self- inflating, bag-valve-mask device. |
|
|
Term
| What is enriched oxygen Ventilation? |
|
Definition
| can provide either a conscious or unconscious patient with up to 100% oxygen |
|
|
Term
| What is the first thing to do when managing a unconscious patient in the dental office? |
|
Definition
|
|
Term
| After assessing their unconsciousness the DH should stop what? |
|
Definition
|
|
Term
| then the DH should activate the? |
|
Definition
|
|
Term
| the dental hygienist should them position the patient how? |
|
Definition
| in a supine position with feet elevated |
|
|
Term
| Then the DH should implement CAB, what does this stand for? |
|
Definition
Circulation
Assess open airway
Breathing and pulse |
|
|
Term
| While waiting on Med services to arrive the DH should? |
|
Definition
| Provide definitive management of unconsciousness |
|
|
Term
| what are some medical emergencies that we should be aware of in the dental office? |
|
Definition
Acute Adrenal Insufficiency
Acute Asthma-Status Asthmaticus
Acute myocardial infarction
Airway Obstruction
Allergic Reactions
Angina
Convulsive Siezures-status Epilepticus
Hyperventilation
Insulin Shock/Diabetic Shock
Local Anesthesia/Epinephrine overdose
Myxedema Coma/ Thyrotoxic Crisis
Syncope/Orthostatic hypotension |
|
|
Term
| In an emergency team member #1 will? |
|
Definition
1. Position patient
2. manages airway
3. Directs emergency care
4. evaluates vital signs
5. Provides basic life support
6. Administers oxygen
7. Administers Drugs
8. Initiates CPR |
|
|
Term
| When a faculty arrives they will take team member #? |
|
Definition
|
|
Term
Which team member will
1.check time at start of emergency
2. bring oxygen apparatus and emergency kit
3. Get oxygen tank ready for use, open regulator valve and turn on flowmeter
4. prepare drugs
5. assist as needed |
|
Definition
|
|
Term
what team member..
1. summon faculty , 911-emergency services and campus security (who must be made aware of any emergency situations and imminent ambulance arrival)
2. monitor pt's vital signs, loosens tight clothing if necessary.
3. Records data on Record of Emergency form
4. Assists as needed |
|
Definition
|
|
Term
| what color is the cylinder the oxygen comes in? |
|
Definition
|
|
Term
| the letters on the O2 tank indicate? |
|
Definition
|
|
Term
| what size cylinder do dental offices normally use? |
|
Definition
|
|
Term
| how much O2 does a E cylinder hold? |
|
Definition
|
|
Term
| on 100% oxygen how long will the E cylinder last a patient? |
|
Definition
|
|
Term
| what allows the pressure of the O2 tank to be released at a reduced rate? |
|
Definition
|
|
Term
| what controls the amount of oxygen the pt is administered? |
|
Definition
|
|
Term
| what does the flow meter gage read? |
|
Definition
|
|
Term
| why must the O2 mask be clear? |
|
Definition
| to monitor the patient and to be sure they do not vomit into the lungs and then aspirate the vomitus into the lungs. also shows when the pt breaths their OWN breath, the mask will fog. |
|
|
Term
| for pts who are not breathing on their own what type of mask should be used? |
|
Definition
| different type of mask or ambubag is needed. |
|
|
Term
| How much oxygen should be administered to a pt theta in not breathing? |
|
Definition
|
|
Term
| what is the main purpose/point of the O2? |
|
Definition
| to force the air into the lungs from the oxygen tank |
|
|
Term
| How much should the flow meter be open to a patient that is breathing? |
|
Definition
|
|
Term
| what are the 6 steps in operating the O2 tank? |
|
Definition
1. open regulator, valve all the way open and 1 turn back
2. open flowmeter to 6-10 liters of O2
3. check face mask hose for twists or knots
4. place the mask over pt's face, should have a good seal
5. when complete, remove mask, turn flowmeter to 0, close tank valve
6. Disinfect the face mask |
|
|
