Emergency Drug Kits: Pharmacological and Technical Considerations

Abstract

The risk for complications while providing dental procedures is greatest when caring for patients having significant medical compromise. It is comforting that significant adverse events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, the office team must be prepared to manage untoward events should they arise. This continuing education article will address basic emergency drugs that should be available in all dental practices and additional agents that become essential for those practices providing various levels of procedural sedation or general anesthesia.

Medical Emergencies in Dental Practice - A Nepalese study

“…Joshi S, Acharya S: Medical Emergencies in Dental Practice -A Nepalese study confirms that the most critical clinical situations such as acute myocardial infarction, cardiac arrest and anaphylaxis are uncommon. [8][9][10][11][12][13][14][15][16][17][18][19] In Nepalese context, only 46.8% practitioners keep emergency drugs and equipment in working place. The essential medical equipment such as oxygen cylinder must be available in breathing difficulty cases or in situations where the patient is unconscious and not ventilating properly.…”

Alergias en la atención dental

“…Las reacciones alérgicas inmediatas leves incluyen prurito, urticaria, erupción cutánea y no están asociadas con problemas respiratorios como obstrucción de la vía aérea y/o cardiovasculares. De igual manera se recomienda evaluar la conciencia del paciente y sus signos vitales 33,48,49 . Se debe administrar un bloqueador de la histamina como difenhidramina, por vía intramuscular o intravenosa en una dosis de 25 a 50 mg para adultos (1 mg/kg, hasta 50 mg para niños) para un efecto más rápido 50,51 .…”

“…mg de cetirizina51,52 . Adicionalmente, se debe recetar un antihistamínico oral para los días siguientes, la receta se debe acompañar con una explicación verbal y escrita de los efectos sedantes de los antihistamínicos33,48,49 .En caso de reacciones alérgicas severas inmediatas como anafilaxia, los signos clínicos pueden aparecer simultáneamente en múltiples órganos. Los signos cutáneos y en la mucosa pueden incluir eritema, prurito y edema, con o sin angioedema.…”

Dental students' ability to locate emergency equipment‐lessons learned from aviation

“…Traditional training in managing medical emergencies in the dental school begins with lecture‐based coursework . Training then continues with evidence‐based instruction on the theory of managing specific emergency situations towards active learning educational methods . Teaching safety in emergency management can be divided into three building blocks: (i) the location of emergency equipment, (ii) the operation of emergency equipment and (iii) the understanding of when and how to properly use a particular piece of equipment.…”

“…1 Training then continues with evidence-based instruction on the theory of managing specific emergency situations towards active learning educational methods. [2][3][4] Teaching safety in emergency management can be divided into three building blocks: (i) the location of emergency equipment, (ii) the operation of emergency equipment and (iii) the understanding of when and how to properly use a particular piece of equipment. To accomplish these three components effectively, proper training of equipment location and operation is best accomplished in an environment that simulates the experience.…”