Medical and dental history
How do you prevent medical emergencies?
Make sure ALL H.H questions are answered
*Avoid assumptions
Follow-up ALL positive responses with further questioning
OBSERVE the patient for signs of stress
what is hyperventilation?
Breathe quickly or deeply and you exhale more than you inhale.
what is diabetes mellitus?
A group of metabolic disorders characterized by persistent hyperglycemia (increased blood glucose)
Type I ( formerly called: insulin-dependent DM or Juvenile Onset)
Type II (formerly called: non–insulin-dependent DM or Adult Onset)
a normal level is 70-110 mg
what is anaphylaxis?
Most severe allergic reaction
An exaggerated hypersensitivity reaction to a previously encountered antigen
Immediate onset after exposure
Can result in death
Signs & Symptoms:
Rapid pulse
Difficulty breathing
Hives
Itchiness
Swelling of lips and tongue
Throat swelling, obstructed air flow
Unconsciousness
what three classification of seizure disorders?
1. generalized seizures
A.tonic-clonic (grand mal)
B. Absence (petit mal)
C. atonic
Partial seizures
A. simple
Localized motor seizure, motor seizure with progression of movements, sensory, psychic, autonomic
B. complex has all 5
What is syncope and what are the synonyms?
Sudden, temporary loss of consciousness owing to a drop in blood pressure, resulting in impaired blood flow to the brain
Synonyms:
Neurogenic syncope
Psychogenic syncope
Simple faint
Vasovagal syncope
Vasodepressor syncope
what are the two types of strokes
Ischemic stroke (most common) occurs when the brain’s blood vessels become narrowed or blocked by fatty deposits or by blood clots or other debris that travel through the bloodstream, most often from the heart, and lodge in the blood vessels of the brain.
Hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Factors related to hemorrhagic stroke include uncontrolled high blood pressure, overtreatment with blood thinners (anticoagulants), trauma, bulges at weak spots in blood vessel walls (aneurysms), or ischemic stroke leading to hemorrhage.
what is a seizure?
A seizure is abnormal electrical activity in the brain
Usually affects how a person feels or acts for a short time
Can be silent
what are the different types of ASA Classification?
I- Healthy, no systemic disease
II- Mild systemic disease or risk factor (well-controlled HTN, Type II DM, Asthma)
III- Moderate or severe systemic disease that limits activity but is not incapacitating (MI or CVA over 6 mo ago, COPD)
IV- Incapacitating disease that is constant threat to life (MI, CVA within last 6 mo, uncontrolled HTN, Type II DM or asthma)
V- Patient not expected to live without operation (end stage renal, hepatic or terminal cancer)
VI- Brain dead
what are Petit Mal/Absence Seizures
Found in only 25% epileptics
Occur mainly in children and adolescence between the ages 3 and 15 yrs.
Incidence decrease with age
Tend to occur shortly after waking or during periods of inactivity
what is the difference between vasodepressor/vasovagal syncope?
simple faint
most frequent type of syncope
usually benign or self-limiting
may be potentially life-threating
MOST COMMON Emergency in the dental office
what is the acronym for the signs of a stroke?
F.A.S.T
does the face look even?
does one arm drift down?
does their speech sound strange?
if you notice any of these signs, its time to call 911
what are the three respiratory emergencies
Asthma attack
2. Airway obstruction (choking)
3. Allergic reaction/Anaphylactic shock
What is the HVCC emergency cart There are 14 things
1. first aid kit 2. Defibrillator AED 3. Series E oxygen tank 4. ambu Bag 5. Pulse oximeter 6. Automated BP Cuff 7. Pocket Mask 8. EpiPen 9. Diphenhydramine( Benadryl) 10. Albuterol inhaler 11. InstaGlucose 12. Blanket 13. CPR board 14. Juice
what are grand mal/tonic clonic seizures?
Most common form of seizure disorder
Present in 90% of epileptics
Commonly brought on by drug withdrawal, stress, fatigue, alcohol, & intoxication
what are the three signs and symptoms of syncope
Presyncope(al) Stage (prodrome)
weak, warm, light-headed, diaphoretic, nausea, tachycardia
Syncopal Stage
hypotensive, bradycardia, pale, shallow
breathing, loss of consciousness
Postsyncope(al) Stage
patient wakes, blood pressure and pulse return to normal
what is angina pectoris
Sensation of pain or pressure due to obstruction or spasm of the coronary arteries.
The narrowing of the coronary arteries results in decreased O2 supply to the myocardium (heart muscle)
A symptom of coronary artery disease
Classified as “stable” or “unstable”
whats the difference between a recuse inhaler and a maintain inhaler
Unlike rescue inhalers that should only be used in an emergency situation, controller inhalers are used routinely, often once or twice daily — even when the patient isn't experiencing any symptoms.
How do we manage syncope?
Place patient in Trendelenburg position
-If pregnant- left lateral decubitus position
Assess Airway
Assess Breathing
Assess Circulation
Monitor vitals
Administer Oxygen 4-6L/min
Loosen tight clothing but keep patient warm
Cold Compress
After episode, reassure patient- can take 20 minutes for full recovery
P-A-B-C
how many people does asthma affect?
25 million people in US
what is postural hypotension?
Drop in blood pressure when going from lying down to sitting up or sitting to standing
Symptoms-Dizziness, Lightheadedness, “Feeling faint”, Syncope, Headaches, Blurred vision, Weakness
Linked To
Hypertension
DM
Heart Failure
Medications
Dehydration
Parkinson’s
B12 deficiency
Alcoholism
what is a heart attack?
a deficient coronary artery blood supply to the myocardium.
Common Cause:
Atherosclerosis
(increased risk->obesity, HTN, male gender, hyperlipidemia, diabetes, stress, smoking
Sudden sharp, knifelike pain lasting 20 min+
Sensation of pressure, tightness, heaviness, crushing
Pain not relieved by nitroglycerin tablets
Irregular pulse & cold clammy skin
Possibly nausea or vomiting
Breathing difficulty
Anxiety, fear
Possible loss of consciousness
Women may have atypical abdominal discomfort, jaw or throat pain, extreme fatigue & shortness of breath
what is an allergic reaction?
Wide range of the body’s physiologic responses caused by abnormal immune response to foreign body
The body’s immune system is not protecting itself against the allergen
Vary in type and severity
-Immediate or Delayed
-Localized or Generalized
what is respiratory alkalosis?
over-breathing (called hyperventilation) that occurs when you breathe very deeply or rapidly
symptoms are deep rapid breathing, drop in BP, hypokalemia, numbness & tingling of extremities, confusion, light headedness
what is the difference from diastole vs systole
Systole occurs when the heart contracts to pump blood out, and diastole occurs when the heart relaxes after contraction