Medical Emergencies in the Dental Practice 2023 – Part 4 – In Real Life!
I was in church recently when an elderly person suddenly hunched over in the pew. She was not responsive. Everyone around her, had their opinions of what to do; “sit her up”, “lie her down in the pew”, “get a glass of water” and so on.
You feel like you are going out on a limb when taking action as a consensus has been arrived at. No, we need to take her out of the pew and lay her down on the floor.
She may have fainted. She came too and was responsive but listless. We lay her on her side just in case she vomited. We kept talking to her to keep her conscious. Her breathing was the normal at 12-20 breathes per minute, and quiet. Her skin colour was slightly pale, but felt warm. This was all the signs of a good perfusion of oxygen to her blood.
However, she did not feel the urge to get up. Amongst some general chit chat to keep her alert, we asked her questions such as:
- Where she was?
- When she last ate?
- Her name?
- Does she need to take any medications?
- Any pain?
The ambulance was called during all this.
Anyway, we learnt that she had gone to an earlier church service at 8am, and it’s now 11.30am. So we gave her some sugar in a glass of water which she is sucked up with a straw.
Then as we continued to talk for another 5 minutes or when she said “I am starting to feel cold”. The sound of her breathing changed and become noisy. Her breathes were longer and become less frequent.
I called to the person who rang the ambulance to call again and tell them the situation has changed.
Her breathing is more laboured and starting to feel cold.
She also was having difficulty answering questions and was becoming confused.
Confusion may be caused by different health problems, such as:
- Alcohol or drug intoxication
- Brain tumour
- Head trauma or head injury (concussion)
- Fever
- Fluid and electrolyte imbalance
- Illness in an older person, such as loss of brain function (dementia)
- Illness in a person with existing neurological disease, such as a stroke
- Infections
- Lack of sleep (sleep deprivation)
- Low blood sugar
- Low levels of oxygen (for example, from chronic lung disorders)
- Medicines
- Nutritional deficiencies, especially niacin, thiamine, or vitamin B12
- Seizures
- Sudden drop in body temperature (hypothermia)
Her confusion was becoming worse and her answering of questions was not making sense. I felt the tension building up in me. This is really going to happen. I may have to start chest compressions.
Then the Ambulance Arrives!
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Next week
Medical Emergencies in the Dental Practice 2023 – Part 5 – The Ambulance Arrives!