Medical Urgencies and Emergencies

1
Medical Urgencies and Emergencies

• Donald Falace, DMD
• Oral Diagnosis and Oral Medicine
• UK College of Dentistry

2
Goals

• Develop a sense of vigilance and anticipation
• Enable you to respond to an urgent medical need
  in a reasonably confident and efficient fashion

3
Urgencies vs. Emergencies

• Urgency a problem that requires prompt response
  it is not immediately life threatening but could
  become so if not resolved promptly
• Syncope
• Hypoglycemia
• Seizure
• Asthmatic attack
• Hyperventilation
• Angina
• Mild allergic reaction
• Stroke
• Emergency a problem that is immediately life
  threatening and requires immediate action
• Cardiac arrest
• Anaphylaxis
• Obstructed airway

4
Be observant!

• Look at and listen to your patient
• Watch for changes in
• Speech (slurring, halting, excessively talkative,
  silent)
• Behavior (becomes quiet, restless, agitated,
  anxious, fearful, uncomfortable, nauseated, has
  difficulty breathing, non-communicative)
• Appearance (pale, ashen, flushed, sweating,
  trembling)

5
Anticipation, Prevention and Planning

• Anticipation What type of urgency/emergency can
  you anticipate with this patient?
• Prevention What can you do to decrease the risk
  of occurrence?
• Planning What would you do if the problem does
  occur?

6
Reality Check

• It is estimated that about 90 of urgencies -
  emergencies can be prevented.
• This means that 10 will occur in spite of our
  best efforts

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UKCD Urgency/Emergency Response Protocol in Clinic

• Attend to the patient
• If conscious, allow patient to assume a
  comfortable position, monitor vital signs, give
  oxygen as needed, try to determine what the
  problem is
• If unconscious, PABCD
• Stay with the patient
• Call for help from your supervising faculty
  member (or any faculty member)
• If not immediately life-threatening and
  additional help is needed, call Oral Surgery
  3-5279
• If cardiac arrest or anaphylaxis, call 3-5200 and
  report code 500 and give location and nature
  of the problem

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Location of Emergency Equipment
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Medical Emergencies Equipment in the Clinic

• Oxygen tank, ambu bag, tubing and mask
• Automated blood pressure cuff and pulse oximeter
• Drug box
• Defibrillator

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Drug Box

• Albuterol inhaler
• Ammonia ampules
• Aspirin
• Diphenhydramine (oral injectable)
• Epinephrine (EpiPen ampules)
• Glucose
• Nitroglycerine (spray tablets)
• Ephedrine (hypotension)
• Solucortef (adrenal crisis)
• Narcan (narcotic overdose)
• Atropine (bradycardia)

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Defibrillator
Located in COD on 2nd, 3rd and 5th floors
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Phone

• Oral Surgery
• 3-5749
• Cardiac Arrest or Anaphylaxis
• 3-5200 and report code 500
• Outside of Medical Center - 911

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Emergency Medicine in DentistryStanley Malamed,
DDS

• Disk 1
• Preparation for emergencies
• Emergency drug kit
• Basic management protocol
• Disk 2
• Altered consciousness
• Respiratory distress
• Allergic response
• Cardiovascular problems