Management of vasovagal syncope on dental chair

1. VASOVAGAL
SYNCOPE
B Y : K A R E E M K A M A L
M E N N A A L L A H A S H R A F
O R A L A N D M A X I L L O F A C I A L S U R G E R Y D E P A R T E M E N T
INTRODUCTION
Vasovagal syncope is typically characterized by precipitating triggers
such as emotional or orthostatic stress and prodromal symptoms due
to activation of the autonomic system, e.g. awareness of fast heart
rate, sweating, pallor or symptoms of cerebral hypoperfusion such as
dizziness, loss of vision and heightened awareness of senses,
particularly auditory.
The duration is short, with prompt recovery on assuming the supine
position.
Typical VVS usually occurs in young subjects and episodes may be
isolated or infrequent, or may occur in cluster.
INCIDENCE
One hundred and forty-
five dentists returned
the questionnaires
yielding a response rate
of 73.2%. Half were male
(50.3%) .
56% of dentists worked
in private dental clinics.
About 67% of the
respondents reported
having encountered any
episodes of medical
emergencies.
Vasovagal syncope was
the most common
medical emergency
experienced by 53.1% of
the dentists.
1)Place patient in Trendelenburg position, i.e., head and chest
slightly below a line parallel to the floor and feet slightly elevated.
2)Administer oxygen ( 4 to 6 L /min by nasal cannula ).
3)Stimulate cutaneous reflexes.
6)Cold towel compresses to forehead and back of head.
7)Administer aromatic ammonia inhalant
8) Reevaluate vital signs.
9) If patient’s condition deteriorates activate EMS.
10)Monitor vital signs.
Management
Trendelenberg
position