ABCDE assessment and the out-of-hospital cardiac arrest

There are few studies investigating the incidence of medical emergencies in dental practice. The most recent study surveying GDPs in Germany found that 93% had dealt with at least one emergency in the preceding year.¹ Whilst life-threatening emergencies were relatively uncommon, 3.5% of dentists encountered an acute coronary syndrome, 1.1% anaphylaxis, 0.8% airway obstruction, 0.6% stroke and 0.3% experienced a patient in cardiac arrest. Many of these emergencies have specific therapies that are beyond the scope of this article, but can be found in the medical emergencies section of the British National Formulary (BNF).² Being able to assess unwell patients rapidly, recognize illness and instigate appropriate treatment can help prevent deterioration and avoid cardiac arrest. Recognizing a cardiac arrest early and managing it appropriately improves the chances of survival.

The Resuscitation Council (UK) recently updated their recommendation for equipment that should be available in dental practice (Table 1).³ The list includes personal protective equipment, such as gloves, facemask and aprons, equipment to support the patient's airway and breathing, such as emergency airways, suction, oxygen cylinder and various oxygen delivery devices. It must also include equipment to aid circulation, including an AED, adhesive defibrillator pads, scissors for removing clothes and a razor for removing excess body hair. The equipment should be regularly checked and immediately accessible. This list does not include the recommended contents of the emergency drug box. Details of these drugs can be found in the dental section of the BNF.²