Dental Office Emergency Protocol

Dental office team members must be prepared to handle various medical emergencies.

In a dental office, employees--including dentists, dental hygienists, dental assistants and dental receptionists--must be prepared to respond to medical emergencies immediately. Most emergencies that take place in a dental office are the result of the stress of a person's daily life combined with the apprehension of going to the dentist, according to "Torres and Ehrlich Modern Dental Assisting." Front desk staff during an emergency must call 911, while other dental team members help with basic life support.

CPR/Defibrillation

As a dental team member in an emergency in which the patient is not breathing, you should know how to initiate cardiopulmonary resuscitation (CPR). This involves tilting the victim's head, lifting the chin and looking and listening for signs of breathing. If the patient is not breathing, pinch his nose tightly with your thumb and forefinger and force two full breaths through the patient's mouth, using a CPR mouth barrier. You then must provide 15 chest compressions after placing the heel of one of your hands over the patient's sternum and the other hand on top of your first hand. Administering CPR and calling 911 is crucial when a patient becomes unconscious while experiencing situations such as a stroke, chest pain or a seizure.

Defibrillation/Medications

When a patient is experiencing cardiac arrest in your dental office, attach one of two pads of an automated external defibrillator to the left side of his torso and the other pad above his right nipple. The defibrillator analyzes the patient's heart rhythm and provides the necessary shock to help restore a normal rhythm to the patient. In addition, know which medications to administer in various dental office emergencies. For example, give nitroglycerin to a patient who has chest pain, epinephrine to a patient who is experiencing an allergic reaction, and diazepam to a seizure patient.

Unconscious/Breathing

If a patient is unconscious, situate her so that her head is lower than her feet, which allows blood to flow away from the stomach and toward the brain. Then, loosen any binding clothes and be prepared to administer oxygen and/or an ammonia inhalant by waving it under the patient's nose several times. Also, if a patient is having trouble breathing, place her in a comfortable position and have her breathe into a paper bag or cupped hands.

Choking

If a patient cannot speak, breathe or cough, his airway is completely blocked. In this situation, you must perform the Heimlich maneuver by making a fist with one hand and placing the thumb side of your hand against the patient's abdomen above the navel. Then, grab the fist with your other hand and thrust both hands into the abdomen, thrusting inward and upward. If the patient is lying down in a dental chair, place the heel of one hand at the patient's abdomen and put your other hand over the first hand. Then, give quick, upward thrusts into the patient's diaphragm until the object is dislodged.

Convulsive Seizure/Diabetes

If a patient has a seizure while in the dental chair, remove all materials from her mouth and make sure she is lying down so that her head, chest and knees are all at the same level. Then, protect the patient from self-injury during the convulsion. When a patient is experiencing a diabetic emergency, give her a sugar packet, concentrated orange juice or another form of concentrated carbohydrate that can be quickly absorbed into the bloodstream.

References

• "Torres and Ehrlich Modern Dental Assisting": by Doni Bird and Debbie Robinson; 2009