Patient care
unexpected Dealing effectively with the
Dental practices should ensure they are equipped to deal with medical emergencies by Donald Oleforo of BOC Healthcare
T
he UK dental industry prides itself on its safety record and its commitment to providing dental treatment as a contribution to improving
general health in the population. However, as in virtually all medical procedures, there is a finite risk of unforeseen events happening, including medical emergen- cies. Dental practices need to be aware of these risks and to take action to minimise their consequences. In this area, the Medical Emergencies
and Resuscitation Standards published by the UK’s Resuscitation Council set out best practice for the industry. This docu- ment, which was revised and reissued in December 2012, stresses that, although medical emergencies are rare in general dental practice, “there is a public expecta- tion that dental practitioners and dental care professionals should be competent in managing common medical emergencies”. The medical emergencies most likely to
be encountered in dental practices include asthma, anaphylaxis, angina, cardiac arrest, epileptic seizure, hypoglycaemia, syncope, choking and aspiration, and adrenal insufficiency. The Resuscitation Council document sets out the initial steps to be taken by practitioners while awaiting professional medical help from the ambulance service. The council also lists emergency drugs and equipment that should be routinely available in all UK dental surgeries. A key resource that should be available is medical oxygen in cylinders. The guidelines say that: “Oxygen cylinders should be of sufficient size to be easily portable, but also allow for adequate flow rates, e.g. 15 litres per minute, until the arrival of an ambulance or the patient fully recovers. “A full ‘D’ size cylinder contains 340 litres
of oxygen and should allow a flow rate of 15 litres per minute for approximately 20 minutes. Two such cylinders may be neces-
sary to ensure the supply of oxygen does not fail when it is used in a medical emergency.” These cylinders should be fitted with a
pressure reduction valve and a flowmeter. An Automated External Defibrillator
(AED) should also be available. The combination of oxygen and AED as a basic medical emergency strategy has been gaining ground across the UK over the last few years. Many football clubs have this kind of equipment, as well as an increasing number of schools. While the resuscitation guidelines do not
have the force of law, they do set a bench- mark for the industry and dental practices need to give them due consideration. Given dentistry’s commitment to health and to providing the highest standards of care for patients, implementing these guidelines should be a priority for all practices.
®
Donald Oleforo is a product manager at BOC Healthcare, part of the Linde Group, specialists in healthcare provision across the globe. BOC Healthcare provides a range of products and services across the Healthcare sector, including essential equipment listed by the Resuscitation Council for use in medical emergencies. For more details, call 0161 930 6096 or email
bochealthcare-uk@boc.com
MINIMUM
RECOMMENDED EQUIPMENT
Minimum
emergency and resuscitation equipment for dental surgeries (Resuscitation Council recom- mendations): All clinical areas should have imme- diate access to resuscita- tion drugs, equipment for airway management and an automated external defibrillator (AED). Staff must be familiar with the location of all resuscitation equipment within their working area.
The following is the minimum equipment recommended: • Portable oxygen cylinder (D size) with pressure reduction valve and flowmeter
• Oxygen face mask with reservoir and tubing
• Basic set of oropharyngeal airways (sizes 1, 2, 3 and 4)
• Pocket mask with oxygen port • Self-inflating bag and mask appa- ratus with oxygen reservoir and tubing (1 litre size bag) where staff have been appropriately trained
• Variety of well-fitting adult and child face masks for attaching to self-inflating bag
• Portable suction with appropriate suction catheters and tubing e.g. the Yankauer sucker
• Single-use sterile syringes and needles
• ‘Spacer’ device for inhaled bron- chodilators
• Automated blood glucose meas- urement device
• Automated External Defibrillator (AED).
Scottish Dental magazine 67
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