General Dental Council and medical emergencies
The General Dental Council (GDC) states: A patient could collapse on any premises at any time, whether they have received treatment or not. It is therefore essential that all registrants must be trained in dealing with medical emergencies, including resuscitation, and possess up to date evidence of capability’.
Planning ahead, there should be at least two people available within the working environment to deal with medical emergencies when treatment is scheduled to take place (in exceptional circumstances, the second person could be a receptionist or a person accompanying the patient).
Members of the dental team must maintain their knowledge and competence to effectively and safely deal with a medical emergency, an important aspect of all dental professionals’ continuing professional development (CPD).
Incidence of medical emergencies
Medical emergencies that have occurred in dental practices include vasovagal syncope, angina, hypoglycemia, epileptic seizures, choking, asthma, anaphylaxis and cardiac arrest. It is estimated that, on average, a general dental practitioner (GDP) will experience a medical emergency at least once every two years.
Vasovagal syncope is the most common emergency encountered. Interestingly, one study showed that 4.8% of all GDPs observed 22% of all syncope’s and that the prevalence of vasovagal syncope tends to decrease with professional experience.
Risk management
Risk management can play an important part in reducing the risk of medical emergencies in the dental practice. It is therefore recommended that all primary care dental facilities have a process for medical risk assessment of their patients.
Anticipation of potential medical emergencies that may arise should be highlighted by taking a thorough medical history which is revised, updated and checked each time the patient presents for treatment. It has been suggested that the presence of an updated medical history may help to minimize the risk of a medical emergency occurring.
National guidance on the management of medical emergencies
The National Institute for Clinical Excellence’s (NICE’s) ‘Medical Emergencies in Dental Practice’ section of the British National formulary (BNF) provides guidelines on the management of the more common medical emergencies which may arise in the dental practice.
Other specific guidance is provided by authoritative bodies including NICE, Addison’s Disease Self-Help Group (adrenal crisis), British Thoracic Society (asthma), British Heart Foundation (cardiac emergencies), Epilepsy UK (epileptic seizures), Stroke Association (acute stroke), Diabetes UK (hypoglycemia), UK Sepsis Trust (sepsis) and Resuscitation Council (UK) (anaphylaxis).
Citation:
JOUR, J. P. (2020). Medical emergencies in the dental practice poster: Revised and updated British Dental Journal. (97), 2, 104 – 229.