Is Your Practice Fully Prepared To Handle Any Type of Emergency?

By Genni Burkhart

In the event of a medical emergency, every second counts. The reality is that it’s not a matter of if but when these situations will occur in your practice. While calling 911 is essential, relying solely on emergency responders (who may take 6-10 + minutes to arrive) could mean the difference between life and death.

Sedation dentists and their entire team must be ready to act immediately. Those critical minutes require swift, decisive intervention. Training, preparation, and the right equipment are essential for ensuring patient safety in sedation dentistry.

Training and Teamwork: Practice Makes Perfect

Emergencies don’t announce themselves – they just happen. That’s why training is so crucial. Whether it's in the waiting room or the operatory, training sessions reinforce the power of teamwork. No one wants to be a "team of one."

Training should be consistent and hands-on, ensuring every team member is ready to act when needed. Emergency scenarios require technical skills, seamless coordination, and communication. Each dental team member should have a clearly defined role and practice their responsibilities regularly to ensure confidence and efficiency in high-stress situations.

Mock drills are an effective way to identify weaknesses in emergency protocols and improve response times. Regular training refreshers help reinforce key skills and maintain preparedness, ensuring that the team is well-equipped to handle a variety of medical emergencies. By fostering a culture of teamwork and readiness, dentists can create a safer environment for their patients and staff.

Common Medical Emergencies

Dental teams must be prepared to handle a range of medical emergencies, including:

• Aspiration: Immediate action includes placing the patient in the Trendelenburg position, aggressive suctioning, and providing 100% oxygen.
• Fire: Fires in the dental operatory can be catastrophic. Understanding the fire triangle (oxidizer, ignition source, and fuel) is key to prevention.
• Syncope: The most common emergency in dental offices, typically caused by a vasovagal reaction.
• Seizures: If a seizure lasts over five minutes, it may be status epilepticus or a seizure that will not stop on its own and requires immediate medical intervention.
• Allergic Reactions: FAST is a helpful mnemonic for remembering the symptoms of anaphylaxis. Onset is usually quick, although it may be delayed 5-20 minutes after exposure.
• Stroke/Cerebrovascular Accidents: Identifying symptoms like facial weakness and speech impairment ensures swift action.
• Local Anesthesia Overdose (LAST): Although rare, LAST requires prompt recognition and management.
• Hypoglycemia: Particularly common in diabetic patients, it must be managed promptly with appropriate glucose monitoring and administration.
• Hypotension and Hypertension: Blood pressure irregularities require careful monitoring and intervention.
• Angina and Myocardial Ischemia: Recognizing both typical and atypical signs ensures timely treatment and preparation for cardiac arrest. An automated external defibrillator (AED) in your office can be life-saving.
• Cardiac Arrest: For cardiac arrest, applying the AED is crucial. Studies have shown that survival rates are significantly higher when bystanders use an AED before EMS personnel arrive. Be familiar with your specific AED model and its recommendations.

Emergency Kits and Crash Carts

A well-equipped emergency kit is essential for responding to medical emergencies in dental offices. Some (not all) of the critical components include:

1. Automated External Defibrillator (AED): A hybrid AED, such as the ZOLL AED Pro®, can provide real-time feedback on chest compressions to both basic and advanced rescuers.
2. King LTS-D Airway: A crucial tool for quickly securing the airway in emergencies.
3. Ambu SPUR II Valve Mask: A disposable resuscitator made from SEBS material to minimize cross-contamination risks.
4. IV Fluids: Normal saline and IV tubing for fluid resuscitation.
5. Countering Agents for Allergic Reactions: As required by state regulations, these include EpiPens, H2 inhibitors, epinephrine, aspirin, and inhalers.
6. Naloxone: Sedation dentists take on significant responsibilities in managing opioid safety. This obligation also includes understanding the medications patients may or may not inform you they're taking. Because of this, naloxone serves as a safeguard, ensuring that emergencies can be managed effectively.

A crash cart or emergency supply backpack on each level is recommended for offices with multiple floors. DOCS Education follows the American Heart Association (AHA) guidelines for certification, ensuring dental professionals stay updated on best practices.

Know How to Use an AED Before Emergencies

Knowing how to use an AED before an emergency is essential because it requires both familiarity with the device and a well-practiced team protocol. In a dental setting, the emergency response team includes the dentist, hygienists, dental assistants, and front office staff, all trained to recognize cardiac arrest, initiate CPR, and use the AED seamlessly to ensure the best possible outcome.

Furthermore, some hybrid AED models allow professionals to override incorrect readings, reducing the risk of misinterpretation. Therefore, ensure the AED is tested regularly and that team members are familiar with its operation through regular training drills.

The Power of Teamwork

In an emergency, the dentist's primary role is coordination. It's the well-trained team that should be able to:

• Call 911 promptly.
• Perform high-quality chest compressions.
• Apply the AED correctly.
• Secure the airway efficiently.
• Administer emergency medications as needed.

Dental teams are much more likely to respond confidently and effectively to medical emergencies if they ensure that every team member knows their responsibilities.

Preparedness Requires A Team Effort

When you step outside your door, the chances of facing an emergency might be low, but they can happen anytime, even when you're not at the dental office. This year's Sedation Dentist of the Year knows firsthand the importance of emergency training, having stepped in twice during crises to provide life-saving aid before paramedics arrived. His experiences are a powerful reminder that medical emergencies don’t wait for the perfect setting, and when they happen, you might be the one who needs to step in. In the clinical setting, emergency response is even more critical and can't be handled by just one person. Without proper preparation and teamwork, handling a crisis becomes dangerous and ineffective.

Every sedation practice must have a clear, coordinated plan that ensures all team members know their roles in a crisis.

Fortunately, DOCS Education offers an extensive course selection to strengthen emergency preparedness. These include on-site drills and training that help teams collaborate to respond effectively.

Author: With over 15 years as an award-winning journalist, editor, and writer, Genni Burkhart has covered everything from politics and healthcare to finance and technology. Editor-in-chief of The Incisor newsletter and blog and features writer at DOCS Education, she brings a refreshing insight and a passion for storytelling to the world of sedation dentistry.