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Medical emergencies at dental office: how prepared are we? a survey

Author: 
Dr. Pratibha Choudhary, Dr. Abhilasha Dixit, Dr. Deepak Raisingani, Dr. Harshit Srivastava and Dr. Akshay Arya
Subject Area: 
Health Sciences
Abstract: 

Background: As it is rightly said, ‘Prevention is always better than cure’. But the question is, how prepared are we to prevent? Mishappenings never knock doors. When they happen, they become a nightmare which neither the doctor nor the patient soon forgets. The purpose of this study was to evaluate that how prepared the dentists are, to manage medical emergencies at their dental offices. Materials and methods: A study was conducted in Rajasthan with 560 dental graduates to determine their knowledge and ability in the management of medical emergencies and assess availability of emergency drugs and equipments in dental offices in India. The questionnaire consisted of thirteen objective questions out of which, six required an answer in yes/No and seven had multiple choices. An informed consent was taken from all the participants. Results: The results of our study showed that 77% of our surveyed dentists took medical history from the patients and 74% got a health history Performa filled. Only 8% had attended a workshop on emergency training or management program. 64% of the clinicians reported of having an emergency kit at their dental office but only 58% could agree that they would be able to manage an emergency condition. A very small number of the participants were confident about administrating IV/IM injection. Majority of the clinicians said that they would keep the patient in trendelenburg position and use an ammonia inhalant in the case of syncope. 65% said that they would ask the patient to cough, examine the mouth and local area and do a Heimlich/triple maneuver if patient is cited with airway obstruction during dental treatment due to aspiration of foreign body.54% said that their immediate action if somebody would not respond to shaking and shouting would be CPR and 27% said EMS. 45% of the dentists chose to give antibiotic prophylaxis before extraction of a tooth in patients with prosthetic heart valve. 63% of the dentists said that dental radiographs, orthodontic brackets and RPDs are procedures can be performed in patients with prosthetic heart valve without giving antibiotic prophylaxis. When asked about the location of chest compression during CPR, 51% marked xiphisternum. 38% of the dentists said that mouth to mouth respiration with nose pinched is the way to give rescue breathing in infants while 33% stood in the favour of mouth to mouth and nose. Conclusion: The knowledge of management and preparedness of dentists surveyed showed a poor and an alarming result.

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