Preparedness of dental practices to treat cardiac arrest: Availability of defibrillators

Laurent, Florian; Augustin, Pascal; Zak, Cathia; Maman, Louis; Segal, Nicolas

doi:10.1016/j.resuscitation.2011.06.013

Cited by 9 publications

(7 citation statements)

References 3 publications

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“…However, only a small portion of respondents to our study reported having a defibrillator but the rate of offices equipped with defibrillator is increased compared to previous studies [5,8,14]. This lack of defibrillator has been explained by the feeling of dental practitioners that this device is not necessary in dental office, too expensive and not mandatory [14]. This also reflects the low prevalence of cardiac arrest in dental offices.…”

Section: Discussionmentioning

confidence: 49%

“…Moreover, the European Resuscitation Council advocates that defibrillators should be available throughout outpatient medical facilities [2]. However, only a small portion of respondents to our study reported having a defibrillator but the rate of offices equipped with defibrillator is increased compared to previous studies [5,8,14]. This lack of defibrillator has been explained by the feeling of dental practitioners that this device is not necessary in dental office, too expensive and not mandatory [14].…”

Section: Discussionmentioning

confidence: 55%

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Medical emergencies in dental practice

Laurent

Augustin

Youngquist

et al. 2014

Med Buccale Chir Buccale

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-Introduction:Dentistry is a clinical activity potentially at risk of medical emergencies and dental practitioners need to be prepared to handle them effectively. Materials and methods: We have contacted 25535 French and Belgian dentists through an online survey which included 37 questions about emergency situations they have experienced, emergency equipment at their disposal, training and self-evaluation of competence in the management of medical emergencies. Results: 1344 were included. The incidence of medical emergencies was 2.1 events per dentists per year, mostly vasovagal syncope, orthostatic hypotension or hypoglycemia. Life-threatening emergencies and cardiac arrests are rare but occur (0.003 cardiac arrests per dentist per year of practice). Nearly one out of five dentists had no emergency equipment at all. While many practitioners are equipped with oxygen (66.8%), few possess a defibrillator (7.7%). Nearly 10% of practitioners report never being trained for medical emergencies. Conclusions: Dental practitioners encounter medical emergencies, mostly benign ones but also, more rarely, life-threatening emergencies. Efforts should be made in the education of dental practitioners regarding the management of medical emergencies during initial and continuing education. The recommended emergency equipment for dental practices should be kept to the minimum necessary in order to increase the number of offices properly equipped.Résumé -Urgences médiales au cabinet dentaire. Introduction : La chirurgie dentaire est une activité clinique au cours de laquelle une urgence médicale peut survenir. Les chirurgiens-dentistes doivent se préparer à les gérer efficacement. Méthodes : Nous avons contacté 25535 dentistes français et belges par le biais d'un sondage en ligne qui comprenait 37 questions. Ce questionnaire portait sur les urgences médicales auxquelles ils ont été confrontés, l'équipement d'urgence à leur disposition, leur formation et une auto-évaluation de leurs compétences dans la gestion des urgences médicales. Résultats : 1344 ont été inclus. L'incidence des urgences médicales était de 2,1 événements par dentiste par an, principalement des malaises vagaux, des hypotensions orthostatiques ou des hypoglycémies. Les urgences vitales et les arrêts cardiaques sont rares, mais ils se rencontrent néanmoins (0,003 arrêt cardiaque par dentiste par année de pratique). Près d'un dentiste sur cinq n'avait pas de matériel d'urgence. Alors que de nombreux praticiens sont équipés d'oxygène (66,8 %) ou d'un tensiomètre (64,5 %), peu possèdent un défibrillateur (7,7 %). Près de 10 % des praticiens déclarent ne jamais avoir été formés pour la prise en charge des urgences médicales. Pour 40 % des praticiens formés, la dernière formation a eu lieu il y a plus de 4 ans. Une large majorité des praticiens se sentent capables de gérer un malaise, tandis que moins de la moitié se sentent en mesure de gérer un arrêt cardiaque. Conclusions : Les chirurgiens-dentistes rencontrent des urgences médicales dans leur pratique, la p...

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 55%

Medical emergencies in dental practice

Laurent

Augustin

Youngquist

et al. 2014

Med Buccale Chir Buccale

Self Cite

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“…In the case of necessity to obtain intravenous access, 0.48% declared that they would never be able to perform it, 21.24% that they would rather not do it, 38.66% responded 'difficult to say', 22.67% responded 'rather yes' and 16.95% were always ready for the procedure. Regarding obtaining intravascular access for fluid infusion and drug delivery, 45.10% declared that they would never perform it, 28.88% that they would rather not do it, 16.47% indicated 'difficult to say', 8.12% as 'rather yes' and 1.43% were always ready for the procedure.…”

Section: Resultsmentioning

confidence: 99%

“…Some modifications of the initial BLS sequence have been proposed; these include changing the position of the dental chair to fully horizontal, with the support of a stool to enhance stability. Endotracheal intubation is not recommended to be performed by dentists; supraglottic airway devices are preferred for airway management. In most countries it is not mandatory for an AED to be included in dental practice equipment; accordingly, an AED is present in <5% of dental offices in Europe, in contrast to the USA, where an AED is available in >10% of dental offices.…”

Section: Introductionmentioning

confidence: 99%

Preparedness and attitudes towards medical emergencies in the dental office among Polish dentists

Smereka

Aluchna

et al. 2019

International Dental Journal

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Background Medical emergencies in dental offices are considered a problem in most countries owing to dentists' concerns about emergency preparedness, practical skills, lifesaving equipment and staff availability. The prevalence of medical emergencies in dental offices and dentists' preparedness have been analysed in several countries but have never been studied in Poland. Aim To assess the prevalence of medical emergencies in dental offices in Poland, as well as dentists’ preparedness and attitudes towards medical emergencies. Methods An 18‐item questionnaire was completed by 419 dentists. It asked for information on their cardiopulmonary resuscitation training, availability of emergency medical equipment in the dental office, prevalence of medical emergencies and self‐assessed competence in various dental office emergencies. Data were analysed using the Statistica 13.3 software package. Variability was measured with standard deviation. Pearson's linear correlation coefficient was used to determine correlation strength. Results The most common medical emergencies in Polish dental offices were vasovagal syncope (46.30% of study participants experienced at least one case in the preceding 12 months), orthostatic hypotension (18.85%), hyperventilation crisis (18.61%), mild allergic reactions (16.23%), hypoglycaemia (15.99%) and seizures (11.81%). The prevalence of medical emergency situations requiring an emergency medical service call or medical assistance within the preceding 12 months was 0 for 80.66% of dentists, one for 12.65%, two for 4.53%, three for 1.20%, four for 0.48%, 5–10 for 0.48% and more than 10 for 0%. As many as 41.29% of the participants did not feel competent in managing sudden cardiac arrest, 74.47% in managing hypertensive crisis, 55.61% in managing asthma, 55.13% in managing anaphylactic shock and 52.99% in managing seizures. Conclusion The prevalence of medical emergencies in dental offices in Poland is comparable with that in other countries. A large number of dentists do not feel competent enough to manage medical emergencies. Better undergraduate and postgraduate training in medical emergencies is recommended, as well as broader availability of emergency medical equipment in the dental office.

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“…Dental professionals will then have to immediately start cardiopulmonary resuscitation (CPR) while the patient is still seated in the dental chair. Some studies have reported on useful tools (a bagvalve-mask device for ventilation, an automated external defibrillator, and emergency drugs) for treating CPA occurring in the dental practice [8][9][10]. Moreover, statistical analyses of medical emergencies in dental practices have been conducted [2,4,11].…”

Section: Introductionmentioning

confidence: 99%

The Effect of the Use of a Stabilizer and Different Height Settings on the Stability of the Dental Chair when Performing High-Quality Chest Compressions

J¹

2015

Emerg Med (Los Angel)

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Background/Aim: In the case of sudden cardiopulmonary arrest (CPA) in a patient in a dental practice, dental professionals have to perform cardiopulmonary resuscitation (CPR) in the dental chair. However, not all dental chairs are stable enough for performing chest compressions, as some do not contain steady support under the backrest. We investigated methods for stabilizing the dental chair to increase the efficacy of chest compressions performed in the chair. Materials and Methods:Chest compressions (with a depth of 5.0 to 6.0 cm) were performed on a CPR manikin that was laid on the backrest of a dental chair. The movement of the chest of the manikin and the displacement of the backrest caused by the chest compressions were recorded as video data, and the mean amplitude of the movement of the backrest at each compression depth was analyzed. We investigated the effect of three different height settings of the dental chair and the use of a round stool as a stabilizer under the backrest on the stability of the dental chair during CPR. Results:Differences in the height settings of the dental chair did not significantly affect the vertical movement of the backrest caused by chest compressions. The mean amplitudes of the movements of the backrest with and without a stabilizer were 1.99±0.74 cm and 0.43±0.18 cm, respectively. Conclusion:The placement of a round stool as a stabilizer under the backrest of a dental chair might increase the effectiveness of chest compressions.

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Preparedness of dental practices to treat cardiac arrest: Availability of defibrillators

Cited by 9 publications

References 3 publications

Medical emergencies in dental practice

Medical emergencies in dental practice

Preparedness and attitudes towards medical emergencies in the dental office among Polish dentists

The Effect of the Use of a Stabilizer and Different Height Settings on the Stability of the Dental Chair when Performing High-Quality Chest Compressions

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