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Medical Emergencies
Basic Life Support
Cardiopulmonary Resuscitation (CPR) involves Basic
Life Support (BLS) and Advanced Life Support (ALS)
2. Check pulse 5-10 seconds; if not sure of palpable pulse within 10 seconds, presume no
pulse
6. Correct technique : Place the heel of 1 hand on the center of victims bare chest & heel
of the other hand on top of the first hand with the fingers interlocking (fingers not in
contact w victims body). Arms straight at the elbow, shoulders directly above hands.
- Jaw lifted w fingers of the other hand placed under bony part
of chin
Causes:
Common anaphylaxis triggers in children are food allergies, such as to
peanuts, tree nuts, fish, shellfish and milk
Certain medications, including antibiotics, aspirin and other over-the-
counter pain relievers, and the intravenous (IV) contrast used in some
imaging tests
Stings from bees, yellow jackets, wasps, hornets and fire ants
Latex
Clinical features
Most commonly affects the Cutaneous, Respiratory,
Cardiovascular, and Gastrointestinal Systems
Dermatologic/ocular: Flushing, urticaria, angioedema, cutaneous and/or
conjunctival injection or pruritus, warmth, and swelling
3. check the airway closely. If needed, establish and maintain an airway and/or provide
ventilatory assistance
4. Assess the level of consciousness and obtain blood pressure, pulse, and oximetry
values
5. Place the patient in the supine position with legs elevated, and begin supplemental
oxygen
6. Adrenaline 1:1000 with a dose of 0.001 ml/kg intramuscullar repeat 3 times for
every 15-20 mins until symptom resolve
Drugs
Beta adrenergic blocker : epinephrine (drug of choice)
Antihistamine H1 blockers
Diphenhydramine - Adults: 25 mg PO q6h for 2-5 d; Children:
1 mg/kg PO q6h for 2-5 d
Hydroxyzine - Adults: 25 mg PO q8h for 2-5 d; Children: 1
mg/kg PO q8h for 2-5 d
Corticosteroid : Hydrocortisone
adults, a dose of 1 mg/kg/d in divided doses is probably
adequate
children, a dose of 0.5-1 mg/kg/d in divided doses is
appropriate
Complications
Complications include :
brain damage
kidney damage
obstructed airway
cardiogenic shock
Arrhythmias
heart attack
death
1) Antiplatelet drugs: aspirin 162 mg or 325 mg orally (chewed and swallowed),clopidogrel 300
mg
2) Antiplatelet agent: aspirin 162 mg or 325 mg orally (chewed and swallowed) in pt. with
suspected or definite MI. Clopidogrel 300 mg is also administered. Antiplatelet agent should
be continued
6) other drugs: B blockers (eg metoprolol), ACE inhibitors (eg ramipril) or angiotensin-
receptor blockers (eg valsartan)
Complications
Sudden death
Arrhythmias
Heart attack
Heart failure
Syncope/ Fainting
1. Syncope is defined as a faint, temporary loss of consciousness due to generalized cerebral
ischemia.
4. Predisposing factors:-
a) Psychogenic factors: fright, anxiety, emotional stress, pain especially sudden and
unexpected, sight of blood/ surgical/ other dental instruments.
b) Non psychogenic factors: erect sitting or standing position, hunger from dieting or
skipping meals, exhaustion, poor physical condition, hot humid crowded environment.
5. Clinical manifestation:-
a. Early: Feeling of warmth, heavy perspiration, nausea, tachycardia, loss of skin color; pale
or ashen- grey skin
b. Late: pupillary dilation, yawning, cold hands & feet, hypotension, bradycardia, dizziness,
visual disturbances, loss of consciousness
Management
PRESYNCOPE
1. Stop the procedure.
2. Position the patient in supine position with the legs are slightly
elevated to increase the venous return to the head.
3. Do the:
A: Airways; check the airways and remove any obstruction to the airways
B: Breathing; check the breathing of the patient by looking at the chest
movement
C: Circulation
D: Drugs
SYNCOPE
- The steps:-
1. Assess consciousness
2. Call for assistance
3. Position the patient: place the patient in supine position
4. Assess and open the airways
5. Assess airways potency and breathing
6. Assess circulation
7. If the patient remains unconscious, immediately reach for medical assistance!
(activate EMS)
8. Administer oxygen
9. Monitor vital signs
10. Provide definitive management:
: Loosening of tight clothes, use respiratory stimulant; aromatic ammonia vapouroles,
: If bradycardia persist, give I.V Atropine 6 mg OR give I.M Mephentramine 10-30mg
11. If delayed patient recovery : proceed by activating EMS
Complications
Reduced level of consciousness: profound state of
unconsciousness associated with depressed cerebral activity
from which the individual cannot be aroused; coma generally
occurs when there is dysfunction or injury involving both
cerebral hemispheres or the brain stem.
Falls
DENTAL EMERGENCY
TRAY
DRUG USES
Inj. Adrenaline (1:1000) Anaphylactic shock
Inj. Hydrocortisone Anaphylactic shock, adrenal crisis, acute severe
asthma
50% Dextrose Hypoglycemia (if the patient is unconscious)