Medical Emergencies in the Dental Practice 2023 – Part 3 – In Surgery Demo
At our Cynergex, at the surgery, yearly Medical Emergency training there is something new to learn or to emphasise.
The most important sign that all is not well with a person is their breathing. Firstly, we don’t normally notice people breathing, as it’s quiet.
Secondly, we don’t notice how many times they breathe as it not normally noticeable.
Below are the numbers of breathing to consider.
Normal Respiratory Rate
Adult
- 12 – 20 per minute
Child (9-15 years)
- 15 – 25 per minute
Shocked Patient
Adult
- Above 25 per minute
- Below 10 per minute
Child (9-15 years)
- Above 25 per minute
- Below 10 per minute
Basically the maths work out for a patient who is going into a cardiac arrest will have one or less breathes every 5 secs.
Start CPR!!!
This indicator is more accurate than feeling for a pulse and responsiveness. Anyway if you start compression and they are not in cardiac arrest, they will let you know straight away!
We still need to do the following:
DRSABCD
Danger – this is along the lines of “you can’t help someone if you can’t help yourself”- make sure you the first aider is not in danger. In a dental situation this could be nearby sharp dental instruments, a slippery floor, or tripping hazards.
Response – check the patient response to stimuli in a progressive manner, starting with your voice, then a gentle tap to the cheek (this stimulates the cranial nerves), then a pin in the soft underpart of the upper arm. If no response, then…
Send – for help. In our surgery we have a red bag that contains our medical emergency kit, so we would call out “Red Bag, Red Bag, Red Bag!” The other staff would respond that they have heard “Red Bag, Red Bag, Red Bag!”. This sets off people to perform necessary tasks – Carry the Red Bag to the area of the emergency; Call the ambulance and if enough staff – document the event.
Why “Red Bag”? This not a normal terminology we would use in our day to day work. To say this is a big deal, rather than “need help”.
Airway – Ensure the airway is clear by tilting the head back and moving the lower jaw forward. This allows direct vision of the airway. Remove any contents such as food vomit saliva.
If the patient is in the surgery, use suction, or a dental mirror to remove the contents.
If not in the surgery, then roll them on to the side away from you so that the contents do not go all over you!
Breathing – for an adult one hand on the diaphragm area on the chest, which is the end of the sternum, just below the rib cage, and the other hand, to keep the head tilted back. Feel for the movement of the diaphragm of the lungs and listen for breathes at the mouth.
Check for 10 seconds. We need to have 2 breathes!
If not breathing then we assume a cardiac arrest
– start Compressions!!!!
Then set up for Defibrillation.
Need an Appointment?
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Next week
Medical Emergencies in the Dental Practice 2023 – Part 4 – In Real Life!