MEDICAL EMERGENCIES

SYNCOPE

• Most common in dental clinic
• Most common complication of LA injection – due to fear
• Cause is anxiety
• Most frequent cause of fainting in dental office - vasovagal syncope/ shock
• Rx is leg end elevation or lie in supine position
• Ammonia smell – hypoglycemia precipitates a syncope

ALLERGY

• C/F – urticarial – red rashes on skin with itchiness & irritability.
• Rx

          o Antihistamine
          o Steroid
          o Patient has penicillin allergy only

DIABETES AND FEBRILE TEMPERATURE ABOVE 102° C

• Always under antibiotic coverage for dental procedure
• Must be below 120
• 100 is normal
• Morning aapointments
• Dry mouth, xerostomia, perio problems, sometimes caries

HYPERTENSION

• If BP shows 210/100 – refer to physician & postpond the treatment.
• Don’t try LA WITHOUT ADRENALINE
• OR DON’T SIMPLY THINK THAT ITS BECAUSE OF FEAR FROM DENTAL SHOW, esp if BP repeatedly shows high ok!

ANAPHYLAXIS

• C/F – broncho constriction

          o Palpitation

• Rx – 1:1000 adrenaline IM/ SubCutaneous MOH**

ANGINA PECTORIS

• Rx –

          o Glyceryl trinitrate
          o Isosorbyl dinitrate } sublingual tabs
          o Nitroglycerin

MYOCARDIAL INFARCTION

• All elective Rx to be done after 6 months
• Even RCT contra – indicated in recent MI

HEART FAILURE

• Rx

          o Treat the patient in upright position or reclined position

ASTHMA

• Constriction & inflammation of bronchiolesAvoid NSAIDS
• Rx

          o Always with inhaler (bronchodialator)
          o In upright position.
          o ACUTE CASES – administer Epinephrine, subcutaneous 1:1000************

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

• 2 – 3 litres of O2 to be given prior to procedure
• O2 mask given to patient
• Never put mask directly on mouth

HYPERVENTILATION

• Low CO2 in body –
• Therefore treatment is CO2 administration
• How can you do that – ask patient to breathe into paper bag(not plastic)
• Caused due to anxiety

RENAL FAILURE

• Surgical procedure best done 24 hours after dialysis