DTA 1100 - Office Emergencies

1. Recognize three factors responsible for the increased risk of life threatening emergencies within the dental office setting.
2. Explain the role and components of the pretreatment physical evaluation to be employed by dentists to prevent life-threatening emergencies within dental office.
3. Utilize the medical history questionnaire, dialogue examination to:
   1. determine the physical and psychological status of a patient.
   2. determine the need for medical consultation.
   3. suggest modifications in planned treatment procedures where indicated.
   4. Updating and recording of medical history at each patient visit.
4. Demonstrate the proper technique for measuring and recording blood pressure, heart rate, respiratory rate, and temperature.
5. Name common errors associated with the recording of blood pressure.
6. Recognize precautions to be observed when treating a patient considered to be a medical risk.
7. Name four components necessary for a dental office to be adequately prepared to rapidly and effectively manage life-threatening situations in the dental office.
8. Obtain certification in CPR from the American Red Cross or American Heart Association.
9. Name the members of the emergency team in the dental office and list the responsibilities of each team member.
10. Demonstrate the ability in mock situations to
    1. perform cardiopulmonary resuscitation.
    2. monitor vital signs
    3. summon medical assistance.
    4. administer ammonia vaporously to a patient who has fainted.
    5. record vital signs, dosages of drugs and times of administration during a simulated office emergency.
11. Name items of emergency equipment which must be available in the dental office.
12. Describe the landmarks, indications, and technique of a cricothyreotomy.
13. Define the term emergency.
14. Explain the importance of keeping complete, accurate records of all treatment within the dental office.
15. Explain the “failure to diagnose” syndrome and describe necessary steps to avoid being charged with failure to diagnose.
16. Describe the necessity for having an emergency kit kept up to date.
17. Describe some drugs found in an emergency kit.
18. Answer questions related to office emergencies as illustrated on VHS tape.

UNIT #2 UNCONSCIOUSNESS

1. Recognize definitions of the following terms: hypoxia, coma, consciousness,  faint, syncope.
2. Compare possible causes of unconsciousness in the dental office.
3. Compare three factors that increase the chances of the loss of consciousness in the dental office.
4. Identify three preventive measures which can be utilized to avoid situations involving the loss of consciousness in the dental office.
5. Demonstrate in mock situations or tape presentations and describe the steps utilized to manage unconsciousness in the dental office, including:
   1. recognition
   2. positioning of the patient
   3. opening the airway
   4. checking airway patency-and breathing
   5. artificial ventilation: mouth to mouth, equipment augmented.

UNIT #3 RESPIRATORY DIFFICULTY

1. Recognize definitions of the following terms:  apnea, dyspnea, hyperventilation.
2. Identify possible causes of respiratory difficulty and their associated frequency of occurrence in the dental office.
3. Discuss the relationship between acute respiratory disorders and stress
4. Identify preventive measures which can be utilized to prevent office emergencies associated with respiratory difficulty.
5. Recognize the pathophysiology associated with each of the conditions listed:
   1. Hyperventilation syndrome
   2. Acute asthmatic attach Acute Pulmonary edema
6. Describe and/or demonstrate the basic steps utilized to manage respiratory difficulty in the dental office, including:
   1. recognition of respiratory difficulty.
   2. termination of the procedure
   3. proper positioning of the patient
   4. monitoring vital signs
   5. managing signs and symptoms
   6. definitive management
   7. maintain oxygen therapy

UNIT #4 ALTERED CONSCIOUSNESS

1. Recognize definitions of the following terms: dizziness, confusion, delirium.
2. Identify possible causes of altered consciousness and their associated frequency of occurrence in the dental office.
3. Name preventive measures which can be utilized to prevent office emergencies associated with altered consciousness.
4. Describe clinical manifestations which can cause altered consciousness:
5. Demonstrate and/or describe the basic steps utilized to manage altered consciousness within the dental office.
   1. Recognition
   2. Termination of procedure
   3. Proper positioning of the patient
   4. Monitoring vital signs
   5. Management of signs and symptoms
   6. Definitive management

UNIT #5 CONVULSIONS

1. Recognize definitions of the following terms: convulsion, epilepsy, status epilepticus, tonic, clonic.
2. Differentiate and/or identify between the three major forms of seizures.
3. Identify etiological factors known to produce clinical convulsive seizures.
4. Identify the primary methods (3) utilized to prevent acute convulsive episodes in the dental office.
5. Recognize medications that are used in long-term drug therapy to minimize the occurrence of seizure activity in epileptics.
6. Identify clinical manifestations of the three clinical phases of a grand mal.
7. Identify six possible causes of convulsive disorders and seizures and their associated incidence of occurrence within the dental office.
8. Describe and/or demonstrate the appropriate management of convulsions in the dental office.

UNIT #6 DRUG RELATED EMERGENCIES

1. Recognize definitions of the following terms: overdose, allergy, allergen, antigen, antibody, atopy, pruritus, urticaria, rhinitis, conjunctivitis, pilomotor erection.
2. Identify three basic principles which should be utilized to prevent drug related emergencies.
3. Name five classifications of adverse drug reactions and describe the clinical signs and symptoms of each type of reaction.
4. Identify six patient factors that predispose a patient to an overdose reaction.
5. Identify five drug factors that must be considered to avoid overdose reactors.
6. Compare the five forms of local anesthetic overdose reactions in regard to:
   1. likelihood of occurrence
   2. time of onset of signs and symptoms
   3. intensity of signs and symptoms
   4. duration of signs and symptoms
   5. primary method of prevention
7. Describe and demonstrate the steps utilized to manage drug related emergencies including:
   1. local anesthetic overdose: mild-rapid onset, mild-slow onset, severe-rapid onset, severe-slow onset.
   2. allergic reactions: skin reactions delayed and immediate, respiratory reactions, general anaphylaxis.

UNIT #7 HAZARD SAFETY

1. Describe what occupational hazards are found in dental offices for employees and what is done to prevent occupational exposure.
2. Describe the use of nitrous oxide scavenging units.
3. Describe the use of mercury spill kits, chemical spill kits, and material data sheets.