Foreword ix
Acknowledgements x
About the companion website xi
1 An overview of the management of medical emergencies and resuscitation in the dental practice 1
Introduction 1
Concept of the chain of survival 2
Incidence of medical emergencies in dental practice 3
General dental council guidelines on medical emergencies 4
Resuscitation Council (UK) quality standards 5
ABCDE assessment of the sick patient 6
Medical risk assessment in general dental practice 7
Principles of safer handling during cardiopulmonary resuscitation 8
Procedure for calling 999 for an ambulance 10
Importance of human factors and teamwork 11
Conclusion 13
References 13
2 Resuscitation equipment in the dental practice 15
Introduction 15
Recommended minimum resuscitation equipment in the dental practice 16
Checking resuscitation equipment and drugs 20
Checking resuscitation equipment following use 22
Care, handling and storage of oxygen cylinders 23
Conclusion 25
References 25
3 ABCDE: Recognition and treatment of the acutely ill patient 26
Introduction 26
Clinical signs of acute illness and deterioration 27
The ABCDE approach 27
General principles of the ABCDE approach 28
The ABCDE approach to the sick patient 28
Principles of pulse oximetry 34
Procedure for administering oxygen to the acutely ill patient 38
Procedure for recording blood pressure 41
Medical emergencies in the dental practice poster 44
Conclusion 46
References 46
4 Respiratory disorders 48
Introduction 48
Management of acute asthma attack 49
Management of hyperventilation 55
Management of exacerbation of chronic obstructive pulmonary disease 56
Procedure for using an inhaler 57
Procedure for using a spacer device 61
Conclusion 64
References 64
5 Cardiovascular disorders 66
Introduction 66
Management of angina 67
Management of myocardial infarction 69
Management of palpitations 73
Management of syncope 74
Conclusion 76
References 77
6 Endocrine disorders 78
Introduction 78
Management of hypoglycaemia 78
Procedure for blood glucose measurement using a glucometer 83
Management of adrenal insufficiency 85
Conclusion 86
References 86
7 Neurological disorders 88
Introduction 88
Management of a generalised tonic-clonic seizure 88
Management of stroke 93
Management of altered level of consciousness 96
Procedure for placing a patient in the recovery position 97
Spinal injury 101
Conclusion 102
References 102
8 Anaphylaxis 104
Introduction 104
Definition 105
Incidence 105
Pathophysiology 105
Causes 106
Clinical features and diagnosis 107
Treatment 109
Risk assessment 113
Conclusion 114
References 115
9 Cardiopulmonary resuscitation in the dental practice 117
Introduction 117
Resuscitation Council (UK) automated external defi brillation algorithm 118
Procedure for cardiopulmonary resuscitation in the dental chair 118
Procedure for performing chest compressions 126
Conclusion 129
References 130
10 Airway management and ventilation 131
Introduction 131
Causes of airway obstruction 132
Recognition of airway obstruction 132
Simple techniques to open and clear the airway 133
Use of oropharyngeal airway 135
Principles of ventilation 138
Treatment of foreign body airway obstruction 147
Conclusion 150
References 150
11 Automated external defibrillation 152
Introduction 152
Ventricular fi brillation 153
Physiology of defi brillation 153
Factors affecting successful defi brillation 154
Safety issues and defi brillation 155
Procedure for automated external defi brillation 155
Conclusion 158
References 158
12 Paediatric emergencies 160
Introduction 160
ABCDE assessment of a sick child 161
Principles of paediatric resuscitation 162
Placing a child into the recovery position 170
Management of foreign body airway obstruction 170
Conclusion 173
References 173
13 An overview of emergency drugs in the dental practice 175
Introduction 175
Adrenaline 176
Aspirin 179
Glucagon 180
Glyceryl trinitrate spray 181
Midazolam 182
Oral glucose solution/tablets/gel/powder 185
Salbutamol inhaler 185
Conclusion 187
References 187
14 Principles of first aid in the dental practice 189
Introduction 189
Priorities of first aid 190
Responsibilities when providing first aid 190
Assessment of the casualty 190
Wounds and bleeding 195
Minor burns and scalds 200
Poisoning, stings and bites 200
Importance of record keeping 202
Summary 203
References 203
15 Professional, ethical and legal issues 204
Introduction 204
The scope of a dental professional's accountability 205
The fifth sphere of accountability 217
Legal requirements for consent and acting in a patient's best interests 218
Duty of confidence owed to patients by dental professionals 226
Conclusion 231
References 232
Index 235
