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Alec  Such
Posted May 18, 2018 by Alec Such
Dental offices need to be inspected thoroughly by an outside vendor or independent third party to ensure substantiation and due diligence while also removing the potential for bias. How can dentists do well during a medical emergency or sedation emergency when their facility lacks lifesaving medication, equipment, and training?

Deaths due to inappropriately used sedation and anesthesia have become a critical safety issue in dentistry dental equipment. Deaths have even occurred in dental offices due to local anesthesia. As a result, criteria are needed for reviewing offices to ensure they are properly prepared and equipped.

These customized audits should focus on every dental office regardless of whether or not a dentist uses sedation there dental file. These audits need to be performed at least every three years to ensure everything is current and up to date.

Also, these audits should cover local anesthesia and/or nitroius oxide, pediatric sedation, minimal sedation, moderate sedation, and deep sedation or general anesthesia. No matter which type of sedation or anesthesia is being delivered, each audit should examine:

Personnel qualifications and training
Proper documentation
The office facility and equipment
Emergency medications
Written emergency protocols for medical and sedation emergencies
Emergency equipment such as basic ventilation and capnography equipment
In addition to meeting these criteria for office inspections, dentists should conduct monthly drills to practice their response to potential sedation and anesthesia emergencies. The entire staff should practice with a different emergency each month. These drills should be recorded in a log book to prove that they have taken place.

Also, offices should use anesthesia and sedation emergency checklists to prevent sedation- or anesthesia-induced medical mishaps. Plus, personnel should participate in medical emergency training or attend a medical emergency lecture once a year. If your office administers any type of sedation, participate in a course that specifically covers sedation each year too.

CANAL Treatment and Training

Medical emergencies happen in dental practices, and office personnel must be ready to react and respond. The five most significant types of emergencies can be summed up with the acronym CANAL, which stands for Cardiac, Airway, Neurological, Allergic (and drug) reaction, and Loss of consciousness. Caregivers should be prepared to provide specific treatment for each of these situations.

Cardiac emergencies include and require:

Chest pain: oxygen, nitroglycerin
Myocardial infarction: oxygen, aspirin
Dysrhythmias: advanced cardiac life support (ACLS) drugs
Sudden cardiac arrest: automated external defibrillator (AED)
Ventricular fibrillation: ACLS drugs
Airway emergencies include and require:

Foreign body obstruction: airway techniques
Bronchospasm; albuterol, oxygen, epinephrine
Larygnospasm: oxygen, succinylcholine
Hyperventilation: calm the patient, rebreath carbon dioxide
Aspiration/emesis: airway techniquesthe
Neurological emergencies include and require:

Seizures: anticonvulsant
Transient ischemic attack: immediate medical attention
Stroke: immediate medical attention
Panic attack: antianxiety agent
Anxiety: antianxiety agent
Allergic and drug reactions include and require: vacuum forming machine dental
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