3. DEFINITION
UNCONSCIOUSNESS : lack of response to
sensory stimulation.
Most common emergency situation reported in
dental clinic is UNCONSCIOUSNESS
20. STEP 3 SUMMONING OF
HELP
IF NO RESPONSE TO PERIPHERAL
STIMULATION
Rescuer calls for assistance immediately by
activating the dental office emergency
system
24. IN PREGNANT PATIENTS
TURN TO LEFT SIDE And tuck a pillow
on right side because the inferior vena cava,
which carries the blood from the lower body is
on the right side and so if she is on the left it
will not be compressed
25. STEP 5
A – Assess and open airway
Opening of airway and restoration of breathing
are most basic and important steps of BLS
26. HEAD TILT CHIN LIFT
APPLYING DOWNWARD PRESSURE ON
HEAD BY USING PALM
APPLYING UPWARD PRESSURE ON
MANDIBLE USING FINGERS
31. STEP 6a :assess airway patency
and (B) Breathing
Assess the patency of breathing
LOOK LISTEN AND FEEL TECHNIQUE
At chest
movements
Feel and hear air at
victims nose
33. STEP 6b:Artifical Ventilation
VICTIM MAY RECEIVE ARTIFICAL
VENTILATION IN ONE OF THE THREE
WAYS
1.EXHALED AIR VENTILATION
2.ATMOSPHERIC AIR VENTILATION
3.O2 enriched Ventilation
42. 3.O2 enriched Ventilation
E cylinder– 10 TO 15L for 30 minutes of
oxygen
It consists of
1.Portable E Cylinder
2.FACE mask
CAPACITY
A <B <C < D Type cylinder
are also available
43. STEP 7
C - Circulation
Monitoring heart rate and blood pressure
Sites FOR Monitoring Heart rate
1.Brachial and Radial Arteries in Arm
2.Carotid Artery in Neck
46. 2 mechanisms explaining the
restoration of circulation by
external cardiac massage
Cardiac pump
Thoracic
pump
47. Cardiac pump during the
cardiac massage
Blood pumping is assured by the
compression of heart between sternum
and spine
STERNUM
HEART
SPINE
Between compressions thoracic cage
is expanding and heart is filled with
blood
THORACIC CAGE
BLOOD
HEART
48. Thoracic pump at the cardiac
massage
During the chest compression blood is
directed from the pulmonary circulation
to the systemic circulation.
pulmonary circulation
systemic circulation.
blood
58. Signs & symptoms
1.
2.
3.
4.
5.
6.
7.
Early
Feeling of warmth
Loss of colour :pale or ashen gray skin tone
Heavy perspiration
Complaints of feeling “bad” or “faint”
Nausea
Blood pressure at baseline
Tachycardia
64. It is a disorder of the autonomic nervous
system in which syncope occurs when the
patient assumes an upright position
Fall in systolic pressure by 20mm of Hg or
greater or a 10mm Hg or greater fall in
diastolic pressure that occurs on standing
Failure of baroreceptor reflex mechanism
POSITION
VARIATION
decrease constriction of peripheral blood vcssels
return of blood to heart
70. Definition
:A sudden
change in behavior due
to excessive electrical activity OF
the brain
Symptoms of seizures differ depending
on what part of the brain is affected.
81. Drug administration or ingestion
Clinical signs and symptoms that result from
overly high blood levels of a drug in various
target organs and tissues
Drug overdose reactions or toxic reactions
Direct extension of normal pharmacologic
actions of the involved drug.
82. Clinical manifestations of local
anesthetic overdose
SIGNS
Low to moderate overdose levels
1. Confusion
2. Talkativeness
3. Apprehension
4. Excitedness
5. Slurred speech
6. Generalized stutter
7. Muscular twitching and tremor of the face
85. Moderate to high blood levels
1.Generalized tonic-clonic seizure,followed
by
2.Generalized central nervous system
depression
3.Depressed blood pressure,heart rate &
respiratory rate
86. Management of a severe LA
overdose with slow or rapid onset
ASSESS CONSIOUSNESS
Activate office emergency team
P – Position patient supine with feet elevated
90.
Also known as Stroke
Defined as any vascular injury that reduces
cerebral blood flow to a specific region of the
brain , causing neurologic impairment
It is a focal neurologic disorder caused by
destruction of brain substance as a result of
intra-cerebral hemorrhage , thrombosis,
embolism or vascular insufficiency.
93. Diagnostic clues
Hypertension (blood pressure above
140/90mm Hg)
Altered consciousness
Hemiparalysis
Headache and blurred vision
Asymmetry of face and pupils of eyes
100. MANAGMENT
Step 1:Termination of dental therapy
Step 1a:Activation of dental office emergency
Step 2: 2:Unconscious patients should be placed
into the supine position with their legs elevated
slightly
102.
Step 3:Removal of dental materials from
mouth
Step 4:A-B-C(basic life support)as needed.
103. DEFINITIVE CARE
Step 5 :D(definitive care)
Step 5a:summoning of medical assistance
Step 5b:IV infusion(if available)of 5%dextrose
and water or of normal saline
107.
Most dangerous complication of diabetes since
the brain is starved of glucose
Diagnosis
Deepening drowsiness
Disorientation
Excitability or aggressiveness in a diabetic
patient, especially if it is known that a meal
has been missed
110.
4 lumps of sugar
Give 150 ml glucose drink
Reassure patient
111.
give sterile glucose IV (20ml of 20-50% of
solution)or IM glucagon 1mg
Call an ambulance
Where possible, defer further immediate dental
treatment until another day.
If unconscious,
112. Management of sudden loss of
consciousness in the absence of
an obvious diagnosis
STEP 1 :Lay the patient flat . Recovery is
almost instantaneous if the patient has simply
fainted . Call for assistance
115.
STEP 4 :
If pulse is palpable give 4sugar lumps orally if the patient has
not completely lost consciousness
or
20ml of 20-50%sterile glucose IV if
unconscious.
GLUCOSE
116.
STEP 5:
Still no improvement –medical assistance should be
summoned.
Give hydrocortisone sodium succinate 200mgIV
Defer further immediate dental treatment until another day.
117. CONCLUSION
UNCONSCIUOSNESS IS THE MOST
COMMON EMERGENCY CONDITION
REPORTED IN DENTAL CLINIC
SO, as a Dentist we all should know how to
manage unconsciousness condition in the
dental clinic