Basic Guide to Medical Emergencies in the Dental Practice PDF
Preview Basic Guide to Medical Emergencies in the Dental Practice
BASIC GUIDE TO MEDICAL EMERGENCIES IN THE DENTAL PRACTICE FM BLBK228-Jevon September29,2009 14:31 CharCount= BASIC GUIDE TO MEDICAL EMERGENCIES IN THE DENTAL PRACTICE Phil Jevon RN,BSc(Hons),PGCE,ENB124 ResuscitationOfficer/ClinicalSkillsLead HonoraryClinicalLecturer WalsallHospital Walsall UK ConsultingEditors CeliaStrickland,BDSDentalPractitioner,Staffordshire,UK TessaMeese,RDN,CertOHE,LCGi,DCPTutor,PostgraduateOffice,NHS WestMidlands,StChad’sCourt,Birmingham,UK JagtarSinghPooni,BSc(Hons),MRCP(England),FRCA,Consultantin Anaesthesia&IntensiveCareMedicine,NewCrossHospital, Wolverhampton,UK A John Wiley & Sons, Ltd., Publication Thiseditionfirstpublished2010 (cid:1)C 2010PhilJevon BlackwellPublishingwasacquiredbyJohnWiley&SonsinFebruary2007. Blackwell’spublishingprogrammehasbeenmergedwithWiley’sglobalScientific,Technical, andMedicalbusinesstoformWiley-Blackwell. Registeredoffice JohnWiley&SonsLtd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ, UnitedKingdom Editorialoffices 9600GarsingtonRoad,Oxford,OX42DQ,UnitedKingdom 2121StateAvenue,Ames,Iowa50014-8300,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabouthowto applyforpermissiontoreusethecopyrightmaterialinthisbookpleaseseeourwebsiteat www.wiley.com/wiley-blackwell. Therightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedinaccordance withtheCopyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,or transmitted,inanyformorbyanymeans,electronic,mechanical,photocopying,recordingor otherwise,exceptaspermittedbytheUKCopyright,DesignsandPatentsAct1988,withoutthe priorpermissionofthepublisher. Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsin printmaynotbeavailableinelectronicbooks. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.All brandnamesandproductnamesusedinthisbookaretradenames,servicemarks,trademarksor registeredtrademarksoftheirrespectiveowners.Thepublisherisnotassociatedwithany productorvendormentionedinthisbook.Thispublicationisdesignedtoprovideaccurateand authoritativeinformationinregardtothesubjectmattercovered.Itissoldontheunderstanding thatthepublisherisnotengagedinrenderingprofessionalservices.Ifprofessionaladviceorother expertassistanceisrequired,theservicesofacompetentprofessionalshouldbesought. LibraryofCongressCataloging-in-PublicationData Jevon,Philip. Basicguidetomedicalemergenciesinthedentalpractice/PhilJevon;consultingeditors, CeliaStrickland,TessaMeese,JagtarSinghPooni. p.;cm.–(Basicguidetodentistryseries) Includesbibliographicalreferencesandindex. ISBN978-1-4051-9784-7(pbk.:alk.paper) 1.Dentistry. 2.Medicalemergencies. 3.Dental emergencies. I.Title. II.Series:Basicguidetodentistryseries. [DNLM:1.EmergencyTreatment–methods. 2.DentalCare–methods. 3.Emergencies. WU105J58b2010] RK51.5.J4752010 617.6’026–dc22 2009033616 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Setin10/12.5ptSabonbyAptara(cid:1)R Inc.,NewDelhi,India PrintedinMalaysia 1 2010 Contents ForewordbyKarenElley ix Acknowledgements x 1 Medicalemergenciesandresuscitationinthedentalpractice: anoverview 1 Introduction 1 Conceptofthechainofsurvival 2 Incidenceofmedicalemergenciesindentalpractice 3 GeneralDentalCouncilguidelinesonmedicalemergencies 5 ResuscitationCouncil(UK)statement 5 ABCDEassessmentofthesickpatient 7 Medicalriskassessmentingeneraldentalpractice 8 Principlesofsaferhandlingduringcardiopulmonary resuscitation 10 Procedureforcalling999foranambulance 11 Conclusion 13 References 13 2 Resuscitationequipmentinthedentalpractice 15 Introduction 15 Recommendedminimumresuscitationequipmentinthe dentalpractice 16 Checkingresuscitationequipmentanddrugs 20 Checkingresuscitationequipmentfollowinguse 22 Conclusion 23 References 23 3 Recognitionofthesickpatient:theABCDEapproach 24 Introduction 24 Clinicalsignsofacuteillness 24 TheABCDEapproach 25 GeneralprinciplesoftheABCDEapproach 26 TheABCDEapproachtothesickpatient 27 Principlesofpulseoximetry 32 Procedureforadministeringoxygentotheacutelyillpatient 37 Procedureforrecordingbloodpressure 40 vi Contents Conclusion 44 References 44 4 Respiratorydisorders 46 Introduction 46 Managementofacuteasthmaattack 47 Managementofhyperventilation 53 Managementofexacerbationofchronicobstructive pulmonarydisease 54 Procedureforusinganinhaler 55 Procedureforusingaspacerdevice 59 Conclusion 62 References 62 5 Cardiacdisorders 64 Introduction 64 Managementofangina 64 Managementofmyocardialinfarction 66 Managementofpalpitations 70 Managementofsyncope 72 Conclusion 74 References 74 6 Neurologicaldisorders 76 Introduction 76 Managementofageneralisedtonic-clonicseizure 76 Managementofstroke 81 Managementofalteredlevelofconsciousness 84 Procedureforplacingapatientintherecoveryposition 85 Spinalinjury 90 Conclusion 90 References 90 7 Endocrinedisorders 92 Introduction 92 Managementofhypoglycaemia 92 Procedureforbloodglucosemeasurementusingaglucometer 98 Managementofadrenalinsufficiency 99 Conclusion 101 References 101 8 Anaphylaxis 103 Introduction 103 Definition 104 Contents vii Incidence 104 Pathophysiology 105 Causes 105 Clinicalfeaturesanddiagnosis 105 Treatment 107 Conclusion 111 References 112 9 Cardiopulmonaryresuscitationinthedentalpractice 114 Introduction 114 ResuscitationCouncil(UK)automatedexternaldefibrillation algorithm 115 Procedureforcardiopulmonaryresuscitationinthedentalchair 115 Procedureforperformingchestcompressions 123 Conclusion 126 References 126 10 Airwaymanagementandventilation 128 Introduction 128 Causesofairwayobstruction 129 Recognitionofairwayobstruction 129 Simpletechniquestoopenandcleartheairway 130 Useoforopharyngealairway 133 Principlesofventilation 136 Treatmentofforeignbodyairwayobstruction 145 Conclusion 148 References 148 11 Automatedexternaldefibrillation 150 Introduction 150 Ventricularfibrillation 151 Physiologyofdefibrillation 151 Factorsaffectingsuccessfuldefibrillation 152 Safetyissuesanddefibrillation 153 Procedureforautomatedexternaldefibrillation 153 Conclusion 156 References 156 12 Paediatricemergencies 158 Introduction 158 ABCDEassessmentofasickchild 159 Principlesofpaediatricresuscitation 161 Placingachildintotherecoveryposition 168 Managementofforeignbodyairwayobstruction 169 viii Contents Conclusion 172 References 172 13 Professionalandlegalissues 174 Introduction 174 Thescopeofadentalprofessional’saccountability 175 Legalrequirementsforconsentandactinginapatient’s bestinterests 186 Dutyofconfidenceowedtopatientsbydentalprofessionals 194 Conclusion 200 References 201 Index 203
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