Prevention and Management of Medical Emergencies
Medical Emergencies Commonly Provoked by Anxiety
though, that many of these diagnoses were presumptive and not completely verified, so the incidence of problems such as “hypoglycemia” may be overstated. The incidence of medical emergencies is higher in
patients receiving ambulatory oral surgery when compared with those receiving nonsurgical care because of the following three factors: (1) surgery is more often stress provoking, (2) a greater number of medications are typically administered to peri operative patients, and (3)
often longer appointments are necessary when performin; surgery. These factors are known to’ increase the likelihood of medical emergencies. Other factors that increase the potential for emergencies are the age of the
patient (very young and old patients being at greater risk), the ability of the medical profession to keep” unhealthy people ambulatory and able to seek dental· care, and the increasing variety of drugs dentists administer in their offices.
Prevention of medical emergencies is the cornerstone of their management. The first step is risk assessment. This begins with a careful medical evaluation that, in the dental office, requires accurately taking a medical history, including a review of systems guided by pertinent positive
responses in the patient’s history. Vital signs should be recorded, and a physical examination (tailored to the patient’s medical history and present problems) should be performed. Techniques for this are described in Chapter 1.
Although any patient can -have a medical emergency at any time, certain medical conditions predispose patients to medical emergencies in the dental office. These conditions are more likely to turn into an emergency
when the patient is physiologically or emotionally stressed. The most common conditions affected or preclpitated by anxiety are listed in Box 2-1. Once those patients who are likely to have medical emergencies are
recognized, the practitioner can prevent most problems from occurring by modifying the manner in which oral surgical care is delivered.
Medical Emergencies Commonly Provoked