Catharine Goodson DDS www.catharinegoodson.com catharine@catharinegoodsondds.com 713-417-9924 Many Dentists fear they are unprepared to effectively recognize, successfully manage and correctly treat medical emergencies that may occur in their practice. This course will provide Dentists and their staff a system to identify emergencies before they occur, the tools to respond successfully to a crisis, and the staff training necessary to prevent confusion and fear in the event of an emergency. Be prepared to rethink your current methods of preparing your staff for the unexpected, unwanted and utterly confusing medical emergencies! This may be the one course you take that you hope to never use! Welcome to Medical Emergency Mastery for Dental Practices You will be prepared to: Recognize impending medical emergencies Construct a Medical History that is comprehensive and elicits Exactly what you need to know in a format that is straightforward for both you and the patient Review the signs and symptoms of the seven most commonly Occurring medical emergencies with emphasis on specific factors that influence dental treatment.
Respond to events with clarity, knowledge and conviction. Outline the specific interceptive, pharmacological and staff Responsibilities necessary in each potential emergency. Review the components of your current emergency drug kit Determine what s in and what s out. Reorganize your kit to improve its friendly factor Refresh your knowledge of equipment and drug essentials. Spreadsheets outlining monthly emergency drills Maintenance logs for equipment and supplies Contents of a concise, effective 911 call Documentation system for post-incident use Reestablish office protocol and train your staff Incorporate streamlined, efficient procedures Designate specific duties and responsibilities for each staff member Customize response protocol for staff of any size
I. Your Medical History (Medical History Provided) Medical Information Review of physical systems Psychological Assessment Dental Readiness II. III. Most Commonly Occurring Medical Emergencies Airway Obstruction Bronchospasm/ Laryngospasm Syncope Hypoglycemia Hyperventilation Allergy (Mild and Severe) Asthma Angina Heart Attack Equipment Portable Oxygen Source Supplies to supplement breathing and non-breathing patient Blood Pressure Cuff Glucose Monitor AED IV. Emergency Drug Kit Epinephrine (Injectable.3 mg/ 2 x 1.5 mg (epi pen Jr.) Benadryl (tablets 25 mg / 50 mg) Ammonia Ampules x 4 Albuterol Inhaler (Proventil) Nitroglycerin (.4 mg tablets or spray) Glucose Substitute (glucose tube or candy/juice) Aspirin (81 mg chewable) Labels to construct a personalized drug kit V. Staff Training Doctor responsibilities Responder 1 (designation of staff member and responsibilities) Responder 2 (designation of staff member and responsibilities) Responder 3 (designation of staff member and responsibilities)
Contents of a 911 Call Script provided Documentation of an incident by use of the S.O.A.P. protocol Worksheets and Labels (included) Emergency Equipment Emergency Simulations Contents of a 911 Call Labels for placement on emergency drugs
Emergency Medical Protocol The 911 Call Script will remain and the front desk When notified by the Team Leader, the responder will phone 911 and state the following. State YOUR name, The DOCTOR S name, PRACTICE location, and crossroads. State the patients, SYMPTOMS, STATUS of the Patient, whether CONSCIOUS of UNCONSCIOUS, STABLE or UNSTABLE, ALERT, etc. State the ENTRANCE into the practice. State whether the entrance is blocked, obstructed, etc. State that someone will greet them. Remember to stay on the phone until told to hang up! Communicate to your team leader that EMS has been summoned and
wait... Emergency Medical Kit Contents Each kit contains the following: Fainting (Syncope). Three ampules of Ammonium Sulfate Mild allergic reaction. Benadryl (50 mg) x 100 tabs Severe allergic reaction (Anaphylaxis). EpiPen (.3 mg) x 1 Chest Pain (Angina). Nitroglycerin tabs (.4 mg) x 30 Asthma Attack. (Albuterol Inhaler) x 1 Heart Attack/Cardiac Arrest (Aspirin) (81 mg chewable) x 100 Low Blood Sugar (Hypoglycemia). 1 Tube Glucose Substitute
Syncope / Fainting Ammonia Ampules Recline patient Break Ammonia ampule to stimulate breathing Oxygen 3-5 L/ minute by nasal canula If unconscious more than one minute, call EMS Courtesy of Catharine Goodson D.D.S. www.catharinegoodsondds.com Catharine@catharinegoodsondds.com Hypoglycemia/ Low Blood Sugar Glucose Substitute Squirt contents in patients mouth Do not use in an unconscious patient Monitor vitals and use Oxygen if necessary Call 911 if patient s condition doesn t improve Courtesy of Catharine Goodson, D.D.S. www.catharinegoodsondds.com Catharine@catharinegoodsondds.com Angina/ Chest Pain Oxygen via mask at 10-15 L/min Nitro(.4mg tab) sublingual or spray (.4mg) one metered dose spray. Can use two tabs or sprays five minutes apart. Take vitals before and during use. Do not use gloves! Call 911 if symptoms don t improve Courtesy of Catharine Goodson, D.D.S. www.catharinegoodsondds.com Mild Allergic Reaction Benadryl Tablets (25 mg) Two tabs immediately, then one every 4-6 hours until rash, itching or hives decreases. Topical hydrocortisone cream may be helpful as well Monitor to determine progression of symptoms, possible use of EpiPen if symptoms worsen. Courtesy of Catharine Goodson, D.D.S. www.catharinegoodsondds.om Catharine@catharinegoodsondds.com
Severe Allergic Reaction/ Anaphylaxis Call 911 Epi Pen(.3mg).Single injection or TwinJet Inject through clothing or directly into the skin on the leg or arm. Monitor vitals closely Courtesy of Catharine Goodson, D.D.S. www.catharinegoodsondds.com Catharine@catharinegoodsondds Asthma Albuterol (Proventil) Inhaler Hold inhaler two inches from patient s mouth and have patient take 2 to 4 puffs. Can be repeated every 4 to 5 minutes until symptoms decrease. Monitor vitals closely. Consider the use of an epi pen if symptoms worsen. Administer oxygen Courtesy of Catharine Goodson, D.D.S. www.catharinegoodsondds.com Catharine@catharinegoodsondds Heart Attack/ Myocardial Infarction Activate EMS Immediately Call 911 Obtain AED/ Activate Oxygen Mask (10-15 L/min) Consider use of nitrous oxide for pain Consider use of nitro tab (.4mg) to differentiate between angina/chest pain. Nitro tab won t relieve chest pain in event of Heart Attack Have patient chew aspirin