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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 4  |  Issue : 2  |  Page : 19-22

A survey on evaluation of preparedness for medical emergencies at dental office


Thai Moogambigai Dental College and Hospital, Mogappair, Tamil Nadu, India

Date of Submission06-Oct-2021
Date of Acceptance06-Oct-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Dr. H Soniya
Thai Moogambigai Dental College and Hospital, Mogappair, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijosr.ijosr_12_21

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  Abstract 


Introduction: Medical emergencies can occur at any time in the dental office. Every health care provider should be aware of recognizing and handling medical emergencies in their respective workplace. All should be trained and frequently updated regarding aiding patient in emergency situations. The aim of this study is to determine the knowledge and preparedness of a dental practitioner to manage medical emergencies at their dental office. Materials and Methods: A self-administered questionnaire comprising of 10 questions was designed relating to medical emergencies that may occur in dental office, its prevention, and management and was distributed to the practicing dentists in and around Chennai. Results: A total of 150 dentists participated in this study. Of these, 48 were BDS graduates and 102 were MDS graduates. Almost 134 have their working place in urban areas, 12 of them have working place in rural areas and 4 of them have their working place in both urban and rural areas. This study shows almost 97% of surveyed dentists enquire medical history, including medication and allergy. Only 60% of dentists record vital signs of their patients. The study shows that only 72.6% were trained for management of medical emergencies in dental office and 94.6% of them responded that training to dentist for the management of medical emergencies is important. It is found that only 68% of participants have been reported to be confident in handling medical emergency situation, and about 27% have been faced with medical emergency for the past 12 months. Conclusion: Dentists being members of the healthcare profession, should be prepared to deal with medical emergencies which may arise at their workplace. A better knowledge of medical emergencies is essential for further development and professional care for people with various medical complications. This will ensure the provision of better and safer dental healthcare services for the population.

Keywords: Adverse effects, dental office, drugs, knowledge, vital signs


How to cite this article:
Soniya H, Manju. A survey on evaluation of preparedness for medical emergencies at dental office. Int J Soc Rehabil 2019;4:19-22

How to cite this URL:
Soniya H, Manju. A survey on evaluation of preparedness for medical emergencies at dental office. Int J Soc Rehabil [serial online] 2019 [cited 2024 Mar 28];4:19-22. Available from: https://www.ijsocialrehab.com/text.asp?2019/4/2/19/331462




  Introduction Top


A medical emergency is generally termed an acute injury or illness that poses an immediate risk to a person's life or long-term health. Medical emergencies can occur at any time in the dental office.[1] Medical emergencies can be alarming to any clinician, but these situations and can be prevented if proper preparations are made.[2] Effective management of medical emergencies in the dental office is ultimately the dentist's responsibility. Lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal action.[3] Fear and anxiety in patient seeking dental treatment may cause measurable metabolic changes, which make these patients prone to such emergencies. The chance of medical emergency increases with the administration of anesthesia and medication, virtually all of which are known to have adverse reactions.[4] Most dental procedures are performed under local anesthesia.[5] The primary prevention by giving prescription may influence their patient's health.[6] Anaphylaxis is defined as a serious allergic reaction that is rapid in onset and may cause death.[7] The worst manifestations are cardiovascular collapse, bronchospasm, and laryngeal edema.[8] General adverse effects include localized reactions like minimal to moderate redness was reported and central nervous system manifestations.[9] A good step in making ready for clinical emergencies is the acquisition of emergency supplies. The circle of neighboring physicians should choose emergency drugs and device that reflect the spectrum of their office's expected emergencies.[10] The most crucial element of nearly all medical emergencies in the dental workplaces is to save patient, or accurate, provide adequate oxygenation to the brain and heart.[11] Therefore, the control of all clinical emergencies ought to ensure that oxygenated blood is being introduced to those important organs. That is constant with basic cardiopulmonary resuscitation, with which the dentist must be in a position.[12] A successful prevention relies on the assessment of a patient's history and physical situation as well as suitable treatment adjustments.[13] The aim of this study is to determine knowledge and preparedness of dentists to manage medical emergencies at their dental offices and assess the availability of medical emergency drugs and equipment.


  Materials and Methods Top


This study was conducted to determine the awareness on medical emergency in dental office among practicing dentists. This study was conducted among dentists practicing in and around Chennai. A valid questionnaire of 10 was designed which was inclusive of both open and close-ended questions relating to medical emergencies that may occur in dental office, its prevention and management. All questions were given two options (Yes/No). The questionnaire was distributed among dentists in and around Chennai who were willing to participate in the study. This is self-reported questionnaire which takes 10 min for completion. The participant of the study includes dentists who were undergraduates, postgraduate with clinics in urban or rural areas or clinics in both urban and rural areas. Questionnaires were manually checked for completion of data. All data were entered in the data entry form. The analysis of data was done and percentage calculation of the collected data was done with simple mathematical calculations.


  Results Top


A total of 150 dentists participated in this study. Of these, 48 were BDS graduates and 102 were MDS graduates. Almost 134 have their working place in urban areas, 12 of them have working place in rural areas and 4 of them have their working place in both urban and rural areas [Graph 1]. This study shows almost 97% of surveyed dentists enquire medical history, including medication and allergy. Only 60% of dentists record vital signs of their patients. The study shows that only 72.6% were trained for management of medical emergencies in dental office and 94.6% of them responded that training to dentist for the management of medical emergencies is important. It is found that only 68% of participants were reported to be confident in handling medical emergency situation, and about 27% have faced with medical emergency in their dental office for the past 12 months [Graph 2].



[Graph 3] shows that among surveyed dentists 41 of them have no emergency drugs and equipment and only 109 have been reported to have emergency drugs and equipment. Adrenalin, glucose are the most commonly stocked drugs and 70% of them have AMBU bag and 38% of them have oxygen cylinders. Other drugs and equipment reported are ammonia (51%), nitroglycerin (78.6%), epinephrine (79%), oxygen (89%), antihistaminic drugs such as phenramine maleate, diphenhydramine, chlorpheniramine (80%), bronchodilator such as salbutamol, albuterol (76.6%), atropine (47%), aspirin (53%), steroids such as hydrocortisone, dexamethasone (70.6%), tranhexaminic acid (3%), Magill forceps, laryngoscope, oropharyngeal tube (1%), I. V cannula (6.6%). [Chart 1] shows that the most common medical emergency reported in dental office faced by participants is syncope (52%). Other medical emergencies faced in dental office reported are hypertension (5%), respiratory depression (2%), hypoglycemia (14%), seizure (14%), hypersensitivity (2%), shock (2%), bleeding disorder (7%), and angina (2%).




  Discussion Top


This study was conducted to assess the knowledge and preparedness of dentists to manage medical emergencies at their dental office. In this study, it is determined that only 72.6% of surveyed dentists are trained for the management of medical emergencies, which is comparatively higher than the one reported by Gupta et al. in which only 42.1% of dentists were reported to be trained.[4] It is found that 94.6% of dentists responded that training to dentists for the management of medical emergency is important, this is comparatively less than Jodalli et al. who reported 97.1% felt training is important.[2] In this study, it is found that 97% of surveyed dentists enquire about medical history, including medication and allergy which is similar to that of Kumarswami et al.[14] About 60% of dentists record vital signs but most of them record only blood pressure and pulse in needed situation. It is important to enquire about medical history, record vital signs because it may give a clue for the possibility of occurrence of medical emergency at dental office. It is found that only 27% of them have experienced medical emergency during their practice. The experience reported only within 12 months was enquired as it may be easy for the dentists to recall the situation. Among the surveyed dentists, only 68% of them are confident in managing medical emergency situations in dental office which is higher than compared to the survey done by Al-Sebaei et al.[15] According to their survey, only 41% of the surveyed dentists were confident in handling medical emergency situation.[15] Even though 72.6% of the dentists were reported to be trained, only 68% of them are confident in handling medical emergency situation. This may be due to improper training to the dentists, short-duration programs, etc., The 27% of dentists who have experienced medical emergency situation at their dental office were enquired about the common medical emergency situation they experienced.

The most commonly reported medical emergency was syncope of 52%, seizure disorder and hypoglycemia 14%, and other emergency situations such as hypersensitivity, shock, angina, respiratory distress, hypertension, bleeding disorders were reported to be occurring <10%. Similar results were obtained in a study done by Jodalli et al.[2] In a study done by Laurent et al.[16] and Gbotolorun et al.,[17] syncope was reported to be the common medical emergency situation encountered by dentists.

On enquiring about the availability of medical emergency drugs, among the surveyed dentists, about 38% of them reported to have no drugs and equipment available in their dental office. This is higher when compared to Chapman's study in which 14% of dentists reported of not having any emergency drugs and equipment.[18] Adrenalin and glucose are the most commonly stocked drug, and 70% of them have AMBU bag, 38% of them have oxygen cylinders. Other drugs and equipment reported are ammonia (51%), nitroglycerin (78.6%), epinephrine (79%), oxygen (89%), antihistaminic drugs such as pheniramine maleate, diphenhydramine, chlorpheniramine (80%), bronchodilator such as salbutamol, albuterol (76.6%), atropine (47%), aspirin (53%), steroids such as hydrocortisone, dexamethasone (70.6%), tranexaminic acid (3%), magill forceps, laryngoscope, oropharyngeal tube (1%), IV cannula (6.6%). According to Amirchaghmaghi et al., nitroglycerin was reported to be the most common drug and syringe and IV cannula were reported to be the most common equipment available in dental office.[19]

Even though the incidence level is reported to be increased when compared to studies done previously, the reported levels are still low and should be improved. It is important for all dentists to attain knowledge about the management of medical emergency. It is suggested that training to dentists about the management of medical emergency should be considered seriously. Many awareness programs, training sessions, long duration training programs should be done. The training must be provided in such a way that the dentists are confident in handling any medical emergency situation during their practice. Proper training, better knowledge of the management of medical emergencies will provide confidence for a dentist to handle it. By properly equipping the office, educating their assistants and staffs, the dentist can ensure that their patients receive essential care in office emergencies.[20] This will provide a fortified dental care for the population.


  Conclusion Top


Dentists being members of the healthcare profession should be prepared to deal with medical emergencies which may arise at their workplace. Dentistry in India has made tremendous progress in different subspecialties of dentistry. A better knowledge of medical emergencies is essential for further development and professional care for people with various medical complications. This will ensure the provision of better and safer dental healthcare services for the population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Protzman S, Clark J, Leeuw W. Management of Medical Emergencies in the Dental Office. Continuing Education Course; 2012. p. 47-54. Available from: https://atdentalcare.com. [Last accessed on 2019 Dec 10].  Back to cited text no. 1
    
2.
Jodalli PS, Ankola AV. Evaluation of knowledge, experience and perceptions about medical emergencies amongst dental graduates (Interns) of Belgaum City, India. J Clin Exp Dent 2012;4:e14-8.  Back to cited text no. 2
    
3.
Mohan M, Sharma H, Parolia A, Barua A. Knowledge attitude and perceived confidence in handling medical emergencies among dental practitioners in Dakshina Kannada, India. OHDM 2015;14:27-31.  Back to cited text no. 3
    
4.
Gupta T, Aradhya MR, Nagaraj A. Preparedness for management of medical emergencies among dentists in Udupi and Mangalore, India. J Contemp Dent Pract 2008;9:3-10.  Back to cited text no. 4
    
5.
Subramaniam S, Neelakantan P. Local anesthesia in dentistry – Clinical Considerations. Int J Drug Dev Res 2013;5:30-6.  Back to cited text no. 5
    
6.
Shahroom NS, Lakshmi T, Roy A. Knowledge of drug prescription among dental and medical student in India – An online survey. J Adv Pharm Educ Res 2017;7:2249-3379.  Back to cited text no. 6
    
7.
Balaji K, Jain AR. Knowledge and practice regarding anaphylaxis among dental students. IJSDR 2017;2:30-6.  Back to cited text no. 7
    
8.
Vaishali S, Roy A. Awareness of Anaphylaxis reaction to local anesthetic drugs among dental students – A cross sectional study. IJPT 2017;9:29338-44.  Back to cited text no. 8
    
9.
Kee YL, Neelakantan P. Local anesthetics in dentistry – Newer methods of delivery. IJPCR 2014;6:4-6.  Back to cited text no. 9
    
10.
Johnston CL, Coulthard MG, Schluter PJ, Dick ML. Medical emergencies in general practice in south-east Queensland: Prevalence and practice preparedness. Med J Aust 2001;175:99-103.  Back to cited text no. 10
    
11.
Varma LS, Pratap K, Padma TM, Kalyan VS, Vineela P. Evaluation of preparedness for medical emergencies among dental practitioners in Khammam town: A cross-sectional study. J Indian Assoc Public Health Dent 2015;13:422-8.  Back to cited text no. 11
  [Full text]  
12.
Gupta T, Aradhya MR, Nagaraj A. Preparedness for management of medical emergencies among dentists in Udupi and Mangalore, India. J Contemp Dent Pract 2008;9:92-9.  Back to cited text no. 12
    
13.
Shampaine GS. Patient assessment and preventive measures for medical emergencies in the dental office. Dent Clin North Am 1999;43:383-400.  Back to cited text no. 13
    
14.
Kumarswami S, Tiwari A, Parmar M, Shukla M, Bhatt A, Patel M. Evaluation of preparedness for medical emergencies at dental offices: A survey. J Int Soc Prev Community Dent 2015;5:47-51.  Back to cited text no. 14
    
15.
Al-Sebaei MO, Alkayyal MA, Alsulimani AH, Alsulaimani OS, Habib WT. The preparedness of private dental offices and polyclinics for medical emergencies. A survey in Western Saudi Arabia. Saudi Med J 2015;36:335-40.  Back to cited text no. 15
    
16.
Laurent F, Augustin P, Youngquist ST, Sega N. Medical emergencies in dental practice. Med Buccale Chir Buccale 2014;20:3-12.  Back to cited text no. 16
    
17.
Gbotolorun OM, Babatunde LB, Osisanya O, Omokhuale E. Preparedness of government owned dental clinics for the management of medical emergencies: A survey of government dental clinics in Lagos. Nig Q J Hosp Med 2012;22:263-7.  Back to cited text no. 17
    
18.
Chapman PJ. Medical emergencies in dental practice and choice of emergency drugs and equipment: A survey of Australian dentists. Aust Dent J 1997;42:103-8.  Back to cited text no. 18
    
19.
Amirchaghmaghi M, Sarabadani J, Delavarian Z. Preparedness of specialist dentists about medical emergencies in dental office-Iran. Aust J Basic Appl Sci 2010;4:5483-6.  Back to cited text no. 19
    
20.
Toback SL. Medical emergency preparedness in office practice. Am Fam Physician 2007;75:1679-84.  Back to cited text no. 20
    




 

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