Proper Preparation Key to Responding to Office Medical Emergencies
LAS VEGAS — Medical emergencies in the office, although rare, do occur, and it only takes about 10 minutes of preparation to prevent the potentially life-threatening consequences of these emergencies, according to a speaker here.
Stanley F. Malamed, DDS, who is a professor of anesthesia and medicine at the Herman Ostrow School of Dentistry of USC in Los Angeles, presented on this topic at the American Dental Association Annual Session this week.
Dr. Malamed noted that fainting, lack of pain control, and underlying health conditions, such as heart problems, asthma, diabetes, or epilepsy can all result in medical emergencies in a clinician's office so staying prepared for all of these is key. Dr. Malamed said a good place to start is to make sure that all office staff are certified in basic life support and urged didactic and clinical courses in emergency medicine.
"Most, but not all areas require CPR retraining every 2 years. Although this may be adequate for licensure, it is not adequate for practice, so I encourage training once every year," Dr. Malamed said.
He stressed the importance of running emergency office drills, and establishing emergency team members to respond to office emergencies.
The first team member, he said, is the person who finds the person in distress, and should always stay with the person who is having the emergency. The first team member should call for help, and the second person to respond then becomes the second team member. The second responder's responsibilities include bringing the emergency kits and appropriate equipment to the scene. The third team member, which could be whomever is left on the scene, is responsible for dialing 9-1-1, and being on hand to meet the emergency responders once they arrive on the scene. Dr. Malamed offered this pearl: "If you work in a high rise building, make sure the staff know to hold the elevator at the bottom of the building. This could add critical time for the emergency responders." He added that the third team member(s) should also record the scene to assist the emergency responders make appropriate decisions about treatment.
Dr. Malamed also told the packed audience that it is important for those responding to remain calm, and know when calling emergency response is appropriate. "If you think you know what is going on and you don’t like it, it is better to call for help then to think you can handle it yourself and make that telephone call too late," Dr. Malamed said.
When training for CPR, it is also key to emphasize to the staff the importance of maintaining a stocked and up-to-date emergency drug kit. He suggested that the following drugs be included as a minimum: epinephrine, histamine-blocker, oxygen with positive-pressure administration capability, nitroglycerin, a bronchodilator, sugar, and aspirin.
He noted that other drugs may be included as the clinician sees fit. He urged that clinicians have 2 automated external defibrillators in the office, and trained staff to use them.
References:
Visit http://www.drmalamed.com/emergency/index.html
