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Managing Adult Medical Emergencies in the Dental Office

Course Number: 516


The primary obligation and ultimate responsibility of oral healthcare personnel (OHCP) is the timely delivery of quality preventive, diagnostic, and therapeutic services within the bounds of the clinical circumstances presented by patients. The incidence of medical emergencies in oral healthcare settings is low. However, an ever-increasing number of patients with medical problems seek dental treatment and OHCP can expect to face situations that may threaten the physical well-being of at-risk patients.

It follows that OHCP must possess the knowledge and skills essential to determine their patients’ physical and emotional ability to undergo and respond to dental care.1 Diagnostic activities should be effective to establish a database that will serve as reference points for significant medical problems and, importantly, the database must identify those at-risk patients who may experience a medical emergency during the perioperative period.

Being ill prepared to respond to emerging perioperative medical events is inexcusable; being subjected to public censure or accused of negligence is an agony best prevented. Consequently, OHCP must P-R-A-Y, i.e., (1) P - repare for the role of “first responders;” (2) R - ecognize predisposing factors and signs and symptoms of medical emergencies; (3) A - ct to stabilize the patient; and (4) Y - ell for help, i.e., notify emergency medical services (EMS).2‑10

OHCP must provide emergency care appropriate for the emergent setting (i.e., oral healthcare facility). At the very minimum, in the event of a life-threatening medical emergency, OHCP must feel comfortable to perform basic life support (BLS) techniques to stabilize the patient until EMS arrives. It must be emphatically stated that advanced life support (ALS) activities should not be attempted without sufficient training and maintenance of skills.