medical emergency- legal issues

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Chapter 14
Occupational Hazards and
Emergencies

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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Objectives
• Upon completion of this chapter, you will
be able to:
– Explain the hazards of mercury contamination
– Explain how to prevent mercury
contamination
– Describe how to avoid the hazards of ionizing
radiation
– Describe universal precautions and PPE
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Objectives (cont’d.)
– Describe how to prevent breakage of an
anesthetic needle
– Explain the treatment needed to remove a
broken endodontic file or reamer
– Explain how the auxiliary can help prevent
soft-tissue injuries
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Objectives (cont’d.)
– Describe ways to prevent the patient from
aspirating foreign objects
– Describe the hazards of nitrous oxide/oxygen
conscious sedation
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Hazards to Dental Personnel
• Use of amalgam has decreased but still
remains a restorative material
– One of the major components is mercury
– Auxiliary should know the protocol for mercury
hygiene
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Hazards to Dental Personnel
(cont’d.)
– Mercury can be absorbed through the skin or
vapors inhaled
• Can cause birth defects, brain dysfunction, kidney
problems, and other problems
• To prevent mercury poisoning:
– Never touch amalgam or mercury with bare
hands
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Hazards to Dental Personnel
(cont’d.)
– Enclose scrap amalgam in a tight container
with used x-ray fixer or a specially prepared
mercury solution
– Try to prevent mercury spills
– If a spill happens:
• Use one of the several devices that can be
purchased for the purpose to collect a spill
• Never use high volume evacuation system or
vacuum cleaner
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Hazards to Dental Personnel
(cont’d.)
– Use water with a high-speed handpiece when
removing worn or broken amalgam
• High volume evacuator tip should be place close to
the operative side to catch any debris
– Routinely have government agency come into
the dental office to monitor mercury levels
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9. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned,
copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Hazards to Dental Personnel
(cont’d.)
• Radiation
– To prevent excessive radiation exposure:
• Never stand in the room with the radiograph unless
there is a lead-lined screen to stand behind
• Always be at least six feet away from the x-ray
head
• Never hold the film in the patient’s mouth
• Wear a personal monitoring device
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Hazards to Dental Personnel
(cont’d.)
• Biological hazards:
– Auxiliary is exposed to biological blood-borne
or saliva-borne pathogens
– Treat each patient with universal precautions
• All patients are treated as if they have infections
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Hazards to Dental Personnel
(cont’d.)
– Use personal protective equipment (PPE)
• Protective eyewear
• Gloves
• Masks
• Protective clothing
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Personal Protective Equipment
Figure14-2A: Protective eyewear
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Personal Protective Equipment
(cont’d.)
Figure14-2B: Vinyl and latex gloves
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Personal Protective Equipment
(cont’d.)
Figure14-2C: Face masks used in dentistry
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Patient Dental Emergencies
• Broken anesthetic needle:
– Patient should be notified by the dentist
– Patient should be kept calm
– Patient may have to be referred to an oral
surgeon for removal
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Patient Dental Emergencies
(cont’d.)
– Auxiliary can help prevent this by:
• Examining the needle prior to the injection
• Keep the patient from hitting or grabbing the
dentist’s hand during the injection
• Separated endodontic reamer or file:
– During endodontic therapy, the endodontic file
may separate and remain in the root canal of
the tooth
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Patient Dental Emergencies
(cont’d.)
– Auxiliary must be prepared to assist the
dentist in removing the fragment
• Soft tissue injury:
– A sharp surgical instrument may slip off the
tooth and lacerate the surrounding soft
tissues
– Auxiliary should be prepared to assist the
dentist with any necessary procedure to treat
the wound
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Patient Dental Emergencies
(cont’d.)
– Auxiliary can help prevent some situations by
proficient suctioning of the area being treated
• Nitrous oxide/oxygen conscious sedation:
– If the dosage is incorrect, it becomes a
general anesthetic and the patient loses
consciousness
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Patient Dental Emergencies
(cont’d.)
– The dental team must properly explain its
effects of conscious sedation to the patient
– Gas should be introduced slowly
• Patients can injure themselves
• Patient can vomit with too high a dosage
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copied, duplicated, or posted to a publicly accessible website, in whole or in part.
Summary
• The dental office can present the dental
team and the patient with hazardous
situations
• Most of these situations can be prevented
• Auxiliary needs to know how to handle
emergencies in case they occur
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