Common medical emergencies

COMMON
MEDICAL
EMERGENCIES
PRESENTED BY
Dr. SREEJAN.C.K, MDS
PROFESSOR
DEPT OF ORAL MEDICINE AND RADIOLOGY
MALABAR DENTAL COLLEGE AND RESEARCH CENTER
MANOOR, EDAPPAL, KERALA

Common Medical Emergencies
FAINTING (SYNCOPE)
It is commonly known as fainting or
temporary loss of consiousness
Although any emergency might occur the
commonly encountered emergencies are :
FAINTING (SYNCOPE)

FAINTING (SYNCOPE)
It is one of the most frequent medical
emergencies in the dental office.
Syncope is caused due to the decrease
in the blood distribution of the brain
and larger vessels within the body.

FAINTING (SYNCOPE)
This reduced blood flow to the
brain causes the patient to lose
consciousness. Both psychological
factors and physical factors can cause
syncope

FAINTING (SYNCOPE)
A patient may complain of symptoms,
and you may notice signs for several
minutes before the patient actually
loses consciousness.

FAINTING (SYNCOPE)
This situation is usually harmless to
the patient as long as someone is
there to manage. Syncope is one
emergency that can be prevented by
close observation of the patient.

FAINTING (SYNCOPE)
Who does syncope affect ?
Stressed patients who see blood or
scared about injections and when the
experience pain or fear

FAINTING (SYNCOPE)
Patients who have missed a meal,
stressed and tired and with previous
history of fainting are most affected.

FAINTING (SYNCOPE)
Seen more Elderly Patients Medically
compromised patients and in males in
the age 16-35.

FAINTING (SYNCOPE)
How can you know beforehand ?
• Ask him whether he is stressed
• Any Previous experiences
• Any Previous complications from
dental treatment

FAINTING (SYNCOPE) - Clinical signs
and symptoms
• Loss of Skin colour in Face (Palor )
• Dizzyness
• Feeling heavy in the head
• Increased Breathing
• Nausea

FAINTING (SYNCOPE) - Management
Lay patient in a horizontal “head
below feet” position (Trendelenburg
position)

Trendelenburg position

In the Trendelenburg position,
the body is laid flat on the back with
the feet higher than the head by 15-30
degrees

Proper Positioning of Patient

Monitor ABC’s (Airway, Breathing,
Circulation)

• Loosen tight clothing and place cold
towel on forehead
• Provide oral glucose in conscious
patients in diabetic patients who
are conscious and able to swallow.

The duration of unconsciousness is
very brief usually only seconds to
minutes.

• Normally Syncope patients recover
easily but if there is delay or if the
Patient doesn’t recover take steps
to shift to a hospital

Video no 1

HYPERVENTILATION
Is due to an increase in frequency
and/or depth of respiration that
results in the patient taking in
too much oxygen.

HYPERVENTILATION
• The patient usually will remain
conscious.
• This medical emergency commonly
occurs when a patient is extremely
anxious or apprehensive before
dental treatment.

HYPERVENTILATION
To prevent or reduce this problem, the
Staff should be alert at all times and
should be prepared to help the patient
deal with severe apprehension in a
positive manner.

ASTHMATIC ATTACK
Asthma is a breathing disorder
characterized by attacks of sudden
onset during which the patient’s
airway narrows, causing difficulty in
breathing and accompanied
by coughing and a wheezing sound.

ASTHMATIC ATTACK
An allergic reaction, severe emotional
stress, or respiratory infection
can trigger an asthmatic attack.

ASTHMATIC ATTACK
It is very important that asthma be
identified on the patient’s medical
history, and that the patient brings the
inhaler with him or her to each dental
appointment.

EPILEPSY ( FITS)
Epilepsy is a neurologic disorder
characterized by recurrent episodes of
seizures.

EPILEPSY ( FITS)
In most patients, these are controlled
with medication; however, under
stressful conditions, they may still
occur.

EPILEPSY ( FITS)
Also known as convulsions, there may be
temporary loss of consciousness
accompanied by uncontrollable
muscular contractions and relaxation.
During this time, the patient sleeps
deeply and may be difficult to awaken.

EPILEPSY ( FITS)
Care should be taken that the patient
doesn’t bite on his tongue and also be
careful of the instruments and
equipments which might injure the
patient or you due to violent jerking
(convulsion)

DIABETES
Diabetes is a metabolic disorder
resulting from an imbalance
in the normal insulin mechanism.

DIABETES
Most diabetic patients are able to
manage the disease by balancing
their food intake, medication, and/or by
taking insulin

DIABETES
Two conditions of concern to the Dental
treatment is hyperglycemia (too much
blood sugar) or hypoglycemia
(too little blood sugar).

DIABETES
Hyperglycemia is a condition where
there is an abnormal increase in the
glucose (sugar) level in the blood.

DIABETES
Hypoglycemia, also known as insulin
shock, is an abnormal decrease in glucose
level in the blood. (Hypoglycemia
means blood sugar that is abnormally
low.)

DIABETES
Hypoglycemia is very dangerous and life
threatening

DIABETES
Hypoglycemia
The most common causes of hypoglycemia
are missing a meal, taking an overdose of
insulin without adequate food intake, and
exercising excessively .

DIABETES
Hypoglycemia
Managed by giving sugar or Glucose if the
patient is conscious or IV administration of
Glucose

DIABETES
Hypoglycemia
If the patient is not responding to
measures immediately shift to Hospital

CHEST PAIN
Can be Due to Angina or Myocardial
Infarction- Heart Attack

CHEST PAIN - Angina
• Pain from angina will usually last from 3
to 8 minutes.
• Pain from angina is relieved or eased
promptly by the administration of
nitroglycerin.
• A patient with angina should include
this information on his or her medical
history.

Heart Attack
In heart attack the muscle of the heart are
affected due to insufficient oxygen. if this
damage is severe, the patient could die,
however, prompt medical treatment can
help reduce damage to the heart.

Heart Attack
Unexplained sudden chest pain with or
without sweating should be treated as a
potential acute myocardial infarction.

ALLERGIC REACTIONS
An allergy, also known as hypersensitivity,
is an altered state of reactivity in body
tissue in response to specific antigens.

ALLERGIC REACTIONS
An antigen is a foreign substance from the
environment such as a chemical, bacteria,
virus, or pollen that causes an immune
response through the production
of antibodies.

ALLERGIC REACTIONS
An antigen that can trigger the allergic
state is known as an allergen.

ANAPHYLAXIS
Severe allergic reations are called
anaphylaxis, also known as a systemic
reaction, are very serious and develop
very quickly.

ALLERGIC REACTIONS
Although the patient’s health history is the
major factor in determining risk of allergy,
every new drug or dental material
introduced to a patient could possibly
produce a reaction.

ALLERGIC REACTIONS
These include swelling, blockage of
air passages, and a drop in blood pressure.
Without appropriate care, the patient may
die within a few minutes.

CHOKING
a patient may swallow or aspirate or
partially swallow a large object. The
foreign body may become lodged in the
throat and cut of air supply, which may
cause the person’s reflex action of
coughing to begin.

CHOKING
If a person can speak, wheeze, or cough,
there is some air supply entering into the
lungs. The patient shows signs of great
anxiety and struggles to remove the
object.

CHOKING
If the object becomes totally lodged and
there is no air supply, the patient is not
able to make any noise or cough
at all. The rescuer must be ready to offer
immediate assistance because the brain
cannot live long without oxygen,
which is supplied from the blood.

CHOKING
The Heimlich maneuvre
Or
Abdominal thrusts

CHOKING
The Heimlich maneuvre
The Heimlich maneuvre is a rescue
method used to forcefully displace
retained air in the diaphragm up and
out the windpipe to dislodge a
foreign object.

The Heimlich maneuvere

CHOKING ADULTS
A choking victim can’t speak or
breathe and needs your help
immediately.

Follow these steps to help a choking
victim:
• From behind, wrap your arms around
the victim’s waist.
• Make a fist and place the thumb side
of your fist against the victim’s upper
abdomen, below the ribcage and
above the navel.

• Grasp your fist with your other
hand and press into their upper
abdomen with a quick upward
thrust.
• Do not squeeze the ribcage;
confine the force of the thrust to
your hands.
• Repeat until object is expelled.

• Video no 2 a and 2

Basic Life Support (BLS)
This is also known as CPR :
Cardio Pulmonary Rescusitation.

Among the possible emergencies
that a dental staff may encounter,
sudden cardiac arrest (SCA) is the
among the most likely to result in
the death of a patient.

In such cases the immediate need is
to revive the patient till expert help
arrives or till the patient reaches a
hospital

• It is the responsibility of the clinic
staff to provide CPR and Basic Life
Support (BLS).
• Failure to do so will amount to
negligence.

1. CALL
Check the victim for responsiveness.
If the person is not responsive and not
breathing or not breathing normally.
Call for help and return to the victim.
How to do CPR

2. PUMP
If the victim is still not breathing
normally, coughing or moving, begin
chest compressions. Push down in the
center of the chest 2 inches 30 times.
Pump hard and fast at the rate of at
least 100/minute, faster than once
per second.

3. BLOW AIR
Tilt the head back and lift the chin.
Pinch nose and cover the mouth with
yours and blow until you see the chest
rise.
Give 2 breaths. Each breath should
take 1 second.

Common medical emergencies

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