3. INTRODUCTION
◘ What is anemergency?
A serious and unexpected situation requiring an
immediate action.
It is an unforeseen combination of circumstances or the
resulting state thatcallsfor an immediate action.
7. SYNCOPE
• Syncope is a short loss of consciousness andmuscle strength,
characterized by a fast onset, short duration, and spontaneous
recovery.
8. Causes
H Hypoxia / Hypoglycemia
E Epilepsy
A Anxiety
D Disordersof brain stem
H Heart attack
E Embolism
A Aortic stenosis
R Arrhythmias
T Tachycardia
CNS causes
CVS causes
9. V Vasovagal causes( common faint)
E Electrolyte abnormalities (ex. hypercalcemia)
S Situational(cough, sneeze, micturation)
S Subclaviansteal syndrome
E ENTcauses (glossopharyngeal neuralgia)
L Low systemic vascular resistance
S Sensitive carotid sinus
Vascular and other causes
10. Symptoms
Breathing – irregular, jerky & gasping
Dilated pupils
Convulsive movements
Bradycardia (<50 beats per minute)
Weak thready pulse
Loss of consciousness
Partial or complete airway obstruction
11. Management
Position: supine position with brain and heart at same level with feet elevated
slightly (10 – 15 degrees).
ABC: basic life support as needed.
Definitive management: -monitor vital signs
-administer aromatic ammonia
-administration of atropine(0.1g/ml)
12. SEIZURE
• It is a paroxysmal disorder of cerebral function
characterized by an attack,involving changes in the
state of consciousness, motor activityor sensory
phenomena.
• Usuallysudden inonset and of brief duration.
• EPILEPSY: “A chronicdisorder in which nerve cell
activity in the brain is disturbed, causingseizures”.
14. PREVENTION
If a patient is known epileptic, make sure he/she has takentheir
regular dose of anti-convulsanton the day of treatment.
Instruct him/her to alert you as the aura of the impending seizure
manifests itself.
Keep life support equipments ready, in case of anemergency status
epilepticus.
15.
16. MANAGEMENT
Self limitingemergency
Position: supinewith patientplaced on flatsurfaces.
Remove dangerous objects from the mouthand around the patient.(ex.
sharp instruments, needles, etc.)
Loosen any tight clothing.
Avoid restraining thepatient.
In case the ictusfails to subside withina maximum of 10 minutes,
declare statusepilepticus and proceed withdefinitive care.
18. HYPOGLYCEMIA
• Hypoglycemia is a clinical syndrome in which low serum (or plasma)
glucose levels lead to symptoms of sympatho-adrenal activation.
Empty stomach/
Morning insulin
Low blood glucose
level
(<50mg/100ml)
Anxious
disposition
Weakness/
dizziness, pale skin,
depressed
respiration
Loss of
consciousness/
syncope
20. MANAGEMENT
Glucose andsugar-containingbeveragesadministeredorally to
conscious patientsforrapid effect.
Alternatively,milkcandy bars, fruit,cheese,etcmaybe adequate
in mildcases.
IV dextroseisindicatedforsevere hypoglycemia,in patientswith
alteredconsciousness and during any restriction oforal intake.
21. TREATMENT
20-25 ml of 50% dextrose should begiven immediately.
Glucagon, 1mg i.m. (or s.c.)
Metformin
Sulfonylureas
23. Airway obstruction
◘ May occur due to:
o Pathology on theairway
o Dental instruments
o Tongue
◘ Patientdemonstrates symptoms ranging from coughing,
gurgling, gagging, to choking & gasping with pain.
◘ Aspired object may pass into the trachea or oesophagus.
27. HYPERVENTILATION
• Excessiverate and depth of respiration leading to abnormal loss of
carbon dioxide from the blood primarily predisposed tostress and
anxiety.
• Characterized by:
Rapid short strained breaths
Cold sweats
Palpitations
Dizziness
Chest muscle fatigue
33. Myocardial infarction
• It is a clinicalsyndrome caused by deficient
coronary arterial blood supply resulting in
ischemia toa region of the myocardium and
causingcellular death and necrosis.
• Predisposing factors:
- atherosclerosis, coronary artery disease
- coronary thrombosis, occlusion and spasm
- undue stress
34. PREVENTION
Avoid overstressing the patient
Supplemental oxygen during the treatment
Pain control during therapy (appropriate use of local anesthesia)
Psychosedation
Elective dental care is avoided until atleast 6 months after MI
IA and PSA nerve blocks should be avoided due to high risk of
hemorrhage.
36. Angina pectoris
• A condition marked by severe pain in the chest, often also spreading to
the shoulders, arms, and neck, owing to an inadequate blood supply to
the heart.
• Types:
- Stable
- Variant
- Unstable
40. Overdose reactions
• An overdose is when a person ingests or takesin more than normal of
recommended or prescribed amount of drug. It can be accidental or
intentional.
• In a dental practice, most common overdosage is by local anesthesia.
42. MANAGEMENT
Administer BLS as needed
100% oxygen, anticonvulsants
Allow recovery to occur
In case of continuationof symptoms, summonEMS
43. allergy
• It is a hypersensitive state of skinand various mucosae acquired
through the exposure to a particular allergen, re-exposure to which
produces a heightened emergent capacity to react.
• Occurring via expression of IgE in response to allergen exposure.
44. Symptoms
Red, itchy, watery eyes
Sneezing, congestion, runny nose
Itchy or sore throat, postnasal drip, cough
45. MANAGEMENT
Reassure the patient
Initiate the BLS as needed
Administer antihistaminics(diphenhydramine 50mg),
epinephrine 0.123-0.3 ml of 1:1000 i.m. or s.c.
Monitor vitals regularly
46. CONCLUSION
As the saying goes, “PREVENTION IS BETTERTHAN CURE”.
ALWAYS BEPREPARED.
Prompt recognition and efficient management of medical emergencies by a
well-prepared dental team that canincrease the likelihood of a safe & a
satisfactoryoutcome.
Basiclife support training – A MUST.
47. REFERENCES
Stanley F. Malamed, Handbook of Local Anesthesia, 6th edition
James R. Hupp, Contemporary Oral and MaxillofacialSurgery, 6th
edition