Only 5 common Medical Emergencies

1. Loss of Consciousness in
Dental Chair
Completed by,
Syed Sarosh Hussain Rizvi
Medical Emergencies

2. Introduction
How to deal with an Emergency
Common Medical Emergencies in Dental Chair
 Vasovagal Syncope
 Seizures
 Acute Hypoglycemia
 Adrenal Insufficiency/Crisis
 Cerebrovascular Accident
Conclusion
Contents

3. Introduction
Emergency is a serious and
unexpected situation
requiring an immediate
action.
It is an unforeseen
combination of
circumstances or the
resulting state that calls for
an immediate action.

4. How To Deal with an Emergency

5. Comprehensive Medical
History
 Detail History
 Past Medical History
 Familial Disease History
 Psychological/ Social Status
 Diet
Prevention

6. Basic Life Support
 Primary response to all
emergencies
 P-A-B-C-D (Position>Airway>
Breathing> Circulation>
Defibrillation)
Affiliation to Definitive
Medical Care
Preparation

7. Emergency Kit
 BP Apparatus
 Oxygen Delivering System
 Glucometer
 Syringes
 I.V Cannula
 Suction
 Oropharyngeal Equipments
 Emergency Drugs
Management

8. Emergency Drugs
 Nitroglycerine
 Epinephrine
 Hydrocortisone Injection
 Aspirin
 Diazepam
 Dextrose Water
 Insulin
 Glucagon
Management

9. Emergencies
Related To Unconsciousness

10.  Syncope is a short loss of consciousness and muscle strength,
characterized by a fast onset, short duration, and spontaneous
recovery.
Vasovagal Syncope

11. Vasovagal Syncope
Muscles Contraction Peripheral Resistance Decrease
Peripheral Blood PoolingDecreased Venous ReturnHeart Rate
Vagal Activation Heart Rate Low Cerebral Blood Flow
Syncope Light Headiness

12.  Management
 Terminate all dental treatment.
 Position patient in supine posture with
legs raised above level of head.
 Crush ammonia ampule under nose.
 Administer O2.
 Monitor vital signs.
 If not recovered other causes of
collapse should be considered.
Vasovagal Syncope

13.  It is a paroxysmal disorder of cerebral function characterized by
an attack, involving changes in the state of consciousness, motor
activity or sensory phenomena.
 Usually sudden in onset and of brief duration.
Patient Common Medical History
Epilepsy
Seizures

14.  Common symptoms of Seizures
Seizures

15.  Management
 Terminate all dental procedures.
 Place in supine position.
 Remove dangerous objects from the
mouth and around the patient (e.g.
sharp instruments, needles, etc. ).
 Place patient on side, and suction
airway.
 Monitor vital signs.
 Initiate basic life support ,if necessary.
 Transport to emergency care facility.
Seizures

16.  Hypoglycemia, also known as low blood sugar, is when blood
sugar decreases to below normal levels. This may result in a
variety of symptoms including clumsiness, trouble talking,
confusion, loss of consciousness, seizures or death.
Patient Common Medical History
Diabetes.
Acute Hypoglycemia

17.  Sign and Symptoms
Acute Hypoglycemia

18.  Management
 Terminate all dental treatment.
 Administer 50mL 50% glucose IV
or IM or 1 mg Glucagon.
 Monitor vital signs.
 Administer O2.
 Transport to emergency care
facility.
Acute Hypoglycemia

19.  Adrenal Insufficiency (crisis) is a medical emergency and potentially
life-threatening situation requiring immediate emergency treatment.
It is a constellation of symptoms that indicate severe adrenal
insufficiency caused by insufficient levels of the hormone cortisol.
Patient Common Medical History
Addison's disease, Steroid therapy and Congenital Adrenal Hyperplasia.
Adrenal Insufficiency

20. Adrenal Insufficiency
Normal Abnormal

21.  Sign and Symptoms
 Abdominal pain.
 Confusion.
 Feeling of extreme fatigue.
 Weakness.
 Nausea.
 Hyperpigmentation.
 Loss of Consciousness.
Adrenal Insufficiency

22.  Management
 Terminate all dental procedure.
 Place patient in supine position, with leg
raised above level of head.
 Administer Corticosteroid (100mg
Hydrocortisone) IM or IV or its equivalent.
 Administer O2, Monitor vital sign.
 Start IV line and a drip of crystalloid solution.
 Start basic life support, if necessary.
 Transport to an emergency care facility.
Adrenal Insufficiency

23. Cerebrovascular Accidents
 Cerebrovascular accident (CVA) is the medical term for a stroke. A
stroke is when blood flow to a part of your brain is stopped either by a
blockage (Ischemic stroke) or the rupture (Hemorrhage stroke) of a
blood vessel.
Patient Common Medical History
Hypertension
Ischemic stroke Hemorrhage stroke

24.  Sign and symptoms
 Headache that can range from mild to
the worst the patient ever experienced.
 Unilateral weakness or paralysis of
extremities or facial muscles or both.
 Slurring of speech or inability to speak.
 Difficulty breathing or swallowing or
both.
 Seizures.
 Visual disturbance.
 Dizziness.
 Loss of consciousness.
Cerebrovascular Accidents

25.  Management
 Terminate all dental treatment.
 Place patient in supine position, with
head slightly raised.
 Maintain airway.
 Monitor vital signs.
 Administer O2.
 Start basic life support, as necessary.
 Transport the patient to an
emergency care facility.
Cerebrovascular Accidents

26. As the saying goes, “PREVENTION IS BETTER THAN
CURE”.
 The first step in management of dental emergencies is to prevent
their Occurrence.
 With proper knowledge medical emergencies and related
complication can be easily prevented.
 “When you prepare for an emergency, the emergency ceases to
exist”.
Conclusion