medical emergencies in oral surgery.pptx

oral surgery

1. MEDICAL EMERGENCIES IN DENTAL OFFICE

2. Presented by: Safura ijaz discipline: bs c . (hons.) dental technology subject: Oral and maxillofacial surgery

3. CONTENTS Introduction Types of emergencies Manifestations Management Summary

4. Introduction What is an emergency? “A serious and unexpected situation requiring an immediate action.”

5. Types of emergencies Hypersensitivity reactions Chest discomfort Angina pectoris Myocardial infarction Respiratory difficulty Asthma Hyperventilation Foreign body aspiration Gastric contents aspiration Altered Consciousness Syncope Postural Hypotension Hypoglycemia Seizure Local anesthetic toxicity Thyroid dysfunction Adrenal insufficiency

6. Respiratory difficulty

7. Foreign body aspiration A condition where fluids or solid particles go into windpipe or lungs instead of being swallowed into esophagus and stomach.

8. Coughing Chocking sensation Stridorous breathing i.e. crowing sounds Severe dyspnea Inability to breath Cyanosis Loss of conciousness Manifestations

9. Management

10. Gastric contents aspiration

11. Coughing Stridorous breathing i.e. crowing sounds Wheezing i.e. cracking sound on chest auscultation Tachycardia Hypotension Dyspnea Cyanosis Manifestations

12. Management

13. Altered consciousness

14. Syncope “A sudden and temporary loss of consciousness due to reduced cerebral blood flow also described as fainting or passing out.”

15. Cerebral vascular accident Emotional distress Anxiety Orthostatic hypotension Seizures Migraines Hypoxia Hypoglycemia Cardiac disrhythma

16. Irregular breathing Dilated pupils Blurred vision Sweating Bradycardia Feeling of warmth Nausea Palpitations Weakness or dizziness Hypotension Loss of consciousness Manifestations

17. Management

18. Seizure A seizure is a burst of uncontrolled electrical activity between brain cells that causes temporary abnormalities in muscle tone or movements, behaviors, sensations or states of awareness.

19. Isolated brief seizure Tonic- clonic movements of trunk and extremities Shaking Loss of consciousness Blank staring Fumbling Vomiting Confused speech Airway obstruction Loss of urinary and anal sphincter control Manifestations

20. Management

21. Repeated or sustained seizure – status epilepticus Administer diazepam 5mg/min IV up to 10mg or midazolam 3mg/min IV or IM up to 6mg until seizure stop. Have someone summon medical assistance. Protect patient from near by objects. Once seizure ceases Place patient on side and suction airway. Monitor vital signs. Initiate BLS, if necessary. Administer oxygen. Transport to emergency care facility.

22. Local anesthesia toxicity

23. Toxicity Manifestation Management Mild toxicity Talkativeness Anxiety Slurred speech confusion Stop administration of local anesthetics. Monitor all vital signs. Observe in office for 1 hour. Moderate toxicity Stuttering speech Nystagmus Tremors Headache Dizziness Blurred vision Drowsiness Stop administration of all local anesthetics. Place in supine position. Monitor vital signs. Administer oxygen. Observe in office for 1 hour. Severe toxicity Seizure Cardiac dysrhythmia Cardiac arrest Place in supine position. If seizure occurs, protect patient from nearby objects. Have someone summon medical assistance. Monitor all vital signs. Administer oxygen. Start an IV line. Administer diazepam 5-10mg or midazolam 2-6mg slowly. Initiate BLS, if necessary. Transport to emergency care facility.

24. Hypoglycemia

25. Mild hypoglycemia Manifestations Hunger Nausea Mood change Weakness Management Terminate all dental treatment. Administer glucose source such as sugar or fruit by mouth. Monitor vital signs. Before further dental care, consult physician if unsure whether or why hypoglycemia occurs.

26. Moderate hypoglycemia Manifestations Anxiety Behaviour change Perspiration Tachycardia Management Terminate all dental treatment. Administer glucose source such as sugar or fruit by mouth. Monitor vital signs. If symptoms do not rapidly improve, administer 50mL 50% glucose or 1mg glucagon IV or IM. consult physician before further dental care.

27. Severe hypoglycemia Manifestations Hypotension Seizures Unconsciousness Management Terminate all dental treatment. Administer 50 mL 50 % glucose IV or IM or 1mg glucagon. Have someone summon medical assistance. Monitor vital signs. Administer oxygen. Transport to emergency care facility.

28. Thyroid dysfunction

29. Manifestations Abdominal pain Cardiac dysrhythmia Hyperpyrexia Nausea Vomiting Nervousness Palpitations Tachycardia Tremor Weakness Management Terminate all dental treatment. Have someone summon medical assistance. Administer oxygen. Monitor vital signs. Initiate BLS, if necessary. Start an IV line with drip of crystalloid solution 150mL/h. Transport patient to an emergency care facility.

30. Adrenal insufficiency

31. Manifestations Abdominal pain Confusion Feeling of extreme fatigue Nausea Myalgia Hypotension Partial or total loss of consciousness Weakness Management Terminate all dental treatment. Place the patient in the supine position with leg raised above head level. Have someone summon medical assistance. Administer corticosteroid – 100mg hydrocortisone IM or IV . Administer oxygen. Monitor vital signs. Initiate BLS, if necessary. Transport patient to an emergency care facility.

32. Cerebro-vascular compromise Alterations in cerebral blood flow can be compromised in 3 principal ways: Embolization of particulate matter from a distant site Formation of a thrombus in a cerebral vessel Rupture of a vessel

33. Manifestations Headache range from mild to worst Unilateral weakness or paralysis of extremities Slurring of speech Difficulty in breathing and swallowing Seizures Visual disturbance Dizziness Partial or total loss of consciousness Management Terminate all dental treatment. Place the patient in the supine position with head slightly raised. Have someone summon medical assistance. Administer oxygen, if loss of consciousness occurs. Monitor vital signs. Initiate BLS, if necessary. Transport patient to an emergency care facility.

34. Thank you