Dental emergencies can occur and having the proper equipment and knowledge is important. An emergency kit should include oxygen delivery equipment, airways, suction, syringes, adrenaline, steroids, glucose, antihistamines, and benzodiazepines. Common dental emergencies include fainting, hypoglycemia, seizures, anaphylaxis, chest pain, and cardiac arrest. Proper management involves maintaining airway, oxygenation, intravenous access, monitoring vitals, and summoning emergency help.

1. Dental emergencies
Dr. kibe
In dental practice, emergences though uncommon do occur
Your knowledge and having right equipment and drugs determine the
outcome

2. Useful emergency kit
• Every practice should posses 02 delivery apparatus or at least air
• The following should be readily available
Oral airway-eg ambu-bag
High vacuum suction
Disposable syriges, needles
• Drugs
Adrenaline, 1mg adrenln in 1 ml saline
Hydrocortisone=100mg and h02 for inj

3. Glucose=dextrose 20 or 50%
Chlorpheniramine 20mg inj
Flumazenil 100microgram/5ml ampoule

4. fainting
Commonest cause of loss of consciousness-appr 2% before or during
rx
Predisposed by pain, anxiety, fatigue, hyperthermia, fasting
Characteristics=dizziness, nausea, pale, cold and clammy skin, a slow
thin pulse, then radip and unconscious and collapse
Prevention
 Avoid predis factrs
 Rx pt in supine position unless contrind in heart failure, pulmo
oedema

5. management
Lower head below or at heart positn-lay flat
Loosen clothing
Monitor pulse. If no rapid recover, reconsider dx
Determine and avoid pred factrs in future

6. Collapsed and in doubt
• Don’t panic
• Collapsedin absence of dx, follow steps
Place in supine. If simple fait recover immediately
No breathing- begin cpr
Maintain airway, provide oxygen
Feel pulse. Absent cardiac arrest-cpr
Iv 20ml 20-50 dextrose
Iv hydrocortisone 200mg
These meaures resolve most cases. Ensure some body has requested for
ambulance

7. hypoglycaemia
• Is acute diabetic emergency
• May result from
 missed mea
Excess insulin
Increased caloric demand due to stress or exercise
Assume hypoglycaemia unless otherwise
Dx
 Disorientation, irritability, incrsd drowsnes, excitability, appear drunk

8. mx
• Concious= glucose po
• Unconscious
Protect airway
Recovery position
Iv 50ml 20-50% dextrose
Alter=1mg glucagon IM

9. fits
• majorit fits need no active intervention as recovery is spontaneous
• Avoid pt injury
• Fits in epileptic may be precipitated by starvation, flicking light,
alcohol, drugs, menses or follow dip faint, stress
• Dx= aura, loss of consciousness, rigid appearance, jerking movesmts,
incontinent urine, tongue bite
• Slow recovery wt sleepy feel and dazed

10. mx
Simple major fit,place in recovery posit
If fits repeated=status epilepticus=emergency
 Iv diazepam 10-20mg
 Assess cardiores function, maintain airway, give 02
 Status not allowed to continue for more than 20 mints=brain damage
and mortality
 If fits not controlled use phenytoin infusion or induce anaesthesia wt
thiopentone and ventilate
 Sort help

11. Corticosteroid use collapse
• Use suppress adrenal response to stress
aim=Prevent collapse stress induced therefor cover stressful
procedure wt 100mg im 30 mints before
If collapse occur=pallor, rapid thin pulse, sudden drop bp, loss of
conscious
Mx
Supine posit
500mg iv hydrocortisone
Ask help-ambulance, exclude other causes

12. Acute chest pain
• Due to myocardium ischaemia
• Differentiate btw angina and myocardial infarction
• Signs=retrosternal pain described as heavy, crushing. Preceded by
effort,emotion,excitement and may radiate to arm, neck, jaw
• Angina rapidly relieved by rest and GTN 0.5 mg sublingual.
• If no relieveof pain, breathlessness, nausea, vomiting, loss of
consciousness, weak irregular pulse=infarct

13. mx
In dental
• Upright suppoterd position
• Summon help-ambulance
• Administer analgesia=nitrous oxide/02 mixture
• Give asprin 75-150mg po
• Prepare if cardiac arrest occur
• In hosp
• Iv 2.5mg diamorphine. Ask help

14. Anaphylactic shock and other drug reaction
• Penicillin commonest offender, 10% cross over wt cephalosporins
• Starts afew minutes after parental
• Sign=
Facial flushing,itching,numbness, cold extremities,nausea, abdominal
pain,, wheezing, facial swelling, rash, cold clummy skin, thin pulse.
Loss of conscious may occur progressing to cyanosis and resp failure
Mx
 Supine post
 Iml of 1 in 1000adrenaline in/sc. Repeat every 15 minutes until
improve

15. • Up to 500mg hydrocortisone iv
• Up to 20mg of chlorpheniramine iv
• 02 by mask

16. Cardiac arrest
• Don’t wait expertise=ACT
• major cause ischaemic heart disease bt others eg acute asthma,
hypothermia, drug overdose
• Dx=sudden loss of consciousness, no breathing, no pulse
• Mx
Call for help
Witnes arrest-a single sharp blow over the heart is worthwhile
Airway-extend neck, clear airway
Listen for breath sounds and feel breath by back hand. If none mouth to
mouth. Begin wt 2 expirations to expand chest

17. • No palpable carotid pulse, then external cardiac massage
• Rate compres/vent
Cpr single rescuer 15 compr to 2 ventilations, Two rescu-5 comp/1
ventilation
Aim 60-8- compr/min

18. Acute asthma
• Allergens, infection, cold, axiety
• Characteristics-chest tight, breathlessness, wheexing expiration
• Unable to talk=potential fatal episode
• Mx
Upright posit
Pt salbutamol
Give 02
Give steroids