Question

Look for 3 emergency cases at the dental chair are related to studying body systems anatomy and find the:

1) causes ( why? It is )

2) anatomic features (tissues, organs, systems) involved one of the vein.

3) way of treatment for this cases

Answer 1

There are various medical emergencies that are associated with dental care.

1. Syncope: It is the most important as well as the most common medical emergency that could arise during the oral examination at the dentisit.

Eitiological factors ( cause )includes:-

• decreased cerebral perfusion .
• hypotension
• adrenal crisis
• hypoglycemia
• stroke

Blood vessel involved in decreased cerebral perfusion is carotid arteries and carotid vien. While during dental procedure there is chance of manipulating the carotid region ( on either side of neck) which results in hypotension and bradycardia, there by resulting in sycope.

Management of sycope

1. maintain supine position
2. check for carotid pulse
3. Check for patient responds ( call out name)
4. Initiate BLS or start CPR
5. Check sugar.
6. Administer Intravenous Dextrose or Oral glucose
7. Administer Adrenaline 1 mg.

2. Airway obstruction another emergency which is associated with dental chair.

Mainly caused due to

• Accidental spillage
• Aspiration of foreign bodies
• Laryngeal spasm

Anatomial part involved is oro-larynx region of respiratory system which results in impaired gas exchange in lungs causing cyanosis, decreased oxygen supply to brain and cardiovascular system.

Management of Airway obstruction:

1. Remove foreign body as soon as possible,
2. Perform Heimlich Thrust to remove any external body.
3. Do oral suctioning to remove any fluids or aspiration.
4. Administer oxygen as per order.
5. Administer Invasive or Non invasive mechanical ventilation to patient.

3. Myocardial infraction (MI) is another emergency which is related with dental care.

The main cause of MI with relation to detal procedures may be:-

• Improper positioning of patient on dental chair.
• Asphyxsia
• Airway obstructions
• Manipulation of carotiod blood vessels resulting in bradycardia and hypotention.

Blood vessels involved are coronary arteries and carotid artery.

Management includes:

1. Administration of Oxygen.
2. Proper position(folwer's position)
3. Administer vasodilators like Nitroglycerine.
4. Shift the patient to higher cardiac center for further management.