Medical emergencies in the dental setting are uncommon but they do happen.
The stress felt by many patients when attending the dentist, and the nature of the treatment, means the risk is higher than in most other settings.
When it does happen, dental team members need to be able to perform lifesaving treatment as if it were an everyday occurrence.
The GDC Standards state that registrants must follow the guidance on medical emergencies and training updates issued by the Resuscitation Council (UK).
This includes ensuring specific resuscitation equipment is available, including access to an automated external defibrillator.
Here are our top tips on helping ensure you are prepared:
1. Make sure you have enough oxygen
How far the practice is from the nearest accident and emergency department will determine how much oxygen you need to have available in your practice. One cylinder should be adequate for most practices, but local policy should dictate whether a second cylinder is required in case the first one runs out, and this may be applicable in remote areas or where traffic can be especially busy.
2. Ensure adequate adrenaline supplies
The UK incidence of anaphylactic reactions is increasing and early treatment with intramuscular adrenaline is the treatment of choice. The first dose should be given without delay. Due to current disruption in the supply of adrenaline auto-injectors (AAIs) practices are requested that when they renew the adrenaline in their anaphylaxis kits they order ampoules, ensuring this includes dosing charts, needles and syringes, and not AAIs. This will reduce the reliance on AAIs and preserve essential EpiPen stocks for lay persons. The Green Book and Resus Council guidance provides additional advice to healthcare professionals on the use of adrenaline in response to anaphylaxis.
3. Store emergency drugs in a safe place
There has been some confusion regarding the storage and availability of emergency drugs, due to conflicting advice from inspectors. Practices must ensure emergency drugs are stored in a safe place, in areas away from public access, and ensure they are stored securely when the practice is closed.
4. Keep up-to-date with training and practice sessions
Ensuring your staff are kept up to date on training for medical emergencies is essential.The GDC give medical emergencies and CPR as an example of CPD content for development outcome C: 'Maintenance and development of knowledge and skill within your field of practice'. Despite the changes to a new enhanced scheme, we recommend that team members do at least 10 hours in every CPD cycle, and at least two hours of CPD on this topic every year. The team should carry out practice sessions throughout the year. These should be documented and areas of learning addressed.
5. Glucagon - be aware of storage and expiry dates
Practices should have glucagon available as part of their emergency drugs. Glucagon can be kept in the fridge between 2C and 8C to increase its lifespan, but if you do this, you must monitor the fridge temperature regularly (ideally daily) to ensure it is being kept within the ideal parameters. If kept at room temperature then it will only keep for 18 months, so the expiry date on the box should be adjusted.
For more detailed guidance, read our advice on medical emergencies for BDA members.
Our ilearn on the Management of medical emergencies in the dental practice (with CPD) is free for BDA members and our next training course is on 26 April 2019 in London – book now.
If you are a BDA Extra or Expert member, you can also talk to us your compliance or health and safety issues, give us a ring on 020 7563 4572 or email firstname.lastname@example.org.
Harriet Purdie, BDA Practice Management Consultant
Adapted from an article by Purdie, H Medical emergencies…are you prepared? BDJ In Practice 2018; 10: 31.
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