CPR Forth Year

1. MEDICAL EMERGENCIES IN THE DENTAL OFFICE
Cardiopulmonary Resuscitation course

2. CPR COURSE CONTENTS
 PREPARATION AND LEGAL CONSIDERATIONS
Dr Nallan Chytanya
Lecturer in Oral Medicine
Department of Biomedical Dental Sciences
College of Dental Sciences

3.  Despite every effort to prevent them, life threatening
emergencies do occur in dental offices.
 Prevention, is not always enough.
 The entire dental office must be prepared fully

4. Guidelines
 Guidelines have been establishes to help doctors and
staff members adequately
 Lists of required personnel, equipment, and emergency
drugs.

5. P.A.B.C.D.
 The doctors should be always expected to
initiate steps of basic life support BLS
 P - positioning
 A - airway
 B - breathing
 C - circulation
 D - definitive treatment

6.  The office staff members must be prepared - in the
doctor’s absence .
1) Staff training should include BLS instruction
2) Office preparation -- posting of emergency
assistance numbers & stocking of emergency
drugs and equipment.

7. Training
 Training of office personnel for BLS
 Ability of the all office staff personnel to administer BLS
and CPR according to AHA
 Its preferable that some personnel prepared for
Advanced Cardiac Life Support (ACLS )
 BLS Drill should be maintained for all personnel

8. Team Management
Duties of team member 1
 Provide BLS as indicated
 Stay with the victim
 Alert office staff member
 Member 2 should gather the emergency kit and portable
oxygen system & bring to the emergency site

9. Duties of team member 2
 Bring emergency kit and O2 to the emergency site
 Check O2 daily
 Check emergency kit weekly

10. Member 3 - circulating nurse or assistant.
Duties of Team member 3:
 Assist with BLS
 Monitor vital signs
 Prepare emergency drugs for administration
 Activate EMS system
 Assist as needed
 Maintain record
 Meet Rescue team at entrance

11. Emergency Practice Drill
 Life threatening conditions occurs infrequently -- Annual
refresher courses
 Periodic in-office drills - efficient emergency teams.
 All members of team should respond exactly as they must
under true emergency condition

12. Office Preparation: Emergency medical assistance
 Whom to call ?????
 The team member who calls EMS- clearly provide
the operator with all requested information.
 Call 997 for ambulance service and nearby
hospital

13. Emergency Drugs and Equipment
Items in an Emergency Drug Kits
 Module 1: Basic emergency kit, critical drugs & equipment
 Module 2 : Noncritical drugs and equipment
 Module 3 : ACLS
 Module 4 : Antidotal drugs

18. Emergency kit

19. IM Injection
Procedure

20. IV Injection
Procedure

21. IV Injection
Procedure

22. Critical Non-injectable Drugs
 The following non-injectable drugs are
considered critical:
 Oxygen
 Vasodilator
 Bronchodilator
 Antihypo-glycemic
 Aspirin

23. Primary Non- injectable : Vasodilator
 Nitroglycerin as a tablet / spray / inhalant --chest pain or
angina pectoris .
 Amyl Nitrate
Non- injectable : Bronchodilator
*Drug of choice Albuterol , ventolin
Non- injectable anti-hypoglycemic : Orange juice
Primary non- injectable antiplatelets: Aspirin
Parasympathetic blocking agent anticholinergic atropine

24. Critical emergency equipment
 O2 delivery system
 Syringes
 Suction and suction tips
 Tourniquets
 Magill intubation forceps

25.  Scalpel or cricothyrotomy device
 Could be added to emergency kit
 Laryngoscope
 Artificial airway, endotracheal tube