Exam Pass Notes

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First Response

• Stop treatment, call for help, and assess danger, response, airway, breathing, and circulation.
• Bring oxygen, an AED, emergency drugs, suction, a spacer, a glucose meter, oral glucose, and any other immediately relevant equipment.
• Any trained registrant may need to coordinate the initial response until roles are clear.
• Call 999 early where there is airway, breathing, or circulation compromise; reduced consciousness; a prolonged seizure; severe asthma; suspected anaphylaxis; adrenal crisis; or poor recovery.

Emergency Drugs and Equipment

• Core dental emergency drugs include adrenaline 1:1000, aspirin, glucagon, GTN spray, midazolam oromucosal solution, oral glucose, oxygen, and a salbutamol inhaler.
• Antihistamines can support mild allergy but must not delay adrenaline when anaphylaxis is suspected.
• Dental nurses may fetch, prepare, assist, record, and escalate. Administration of medicines must follow training, competence, legal authority, and local protocol.
• Missing spacers, oxygen, glucose testing devices, AED access, or expired drugs are active patient-safety risks.

Common Non-Cardiac Emergencies

• Syncope: lay the patient flat, raise the legs, reassure, monitor, and reassess if recovery is delayed.
• Anaphylaxis: if airway, breathing, or circulation are affected call 999, give oxygen, give adrenaline according to protocol, and record actions clearly.
• Asthma: sit the patient upright, give salbutamol via a large-volume spacer, give oxygen according to protocol, and call 999 if severe or not improving.
• Seizure: protect from injury, time the seizure, do not restrain and do not put anything in the mouth. Escalate if the seizure is prolonged, repeated, atypical, a first episode, associated with injury, or if recovery is poor.
• Hypoglycaemia: give oral glucose if the patient is conscious and can swallow safely. If unconscious or uncooperative, follow protocol for glucagon. Do not give oral glucose when swallowing is unsafe.
• Adrenal crisis: treat steroid emergency cards as urgent, call 999, support airway, breathing and circulation, and communicate the need for emergency hydrocortisone if relevant.

Records and Debrief

• Record symptoms, triggers, times, observations, drugs given, oxygen, who was present, and details of ambulance handover.
• Restock and check equipment before resuming normal activity.
• Debrief without blame and include the dental nurses who witnessed the event.
• Speak up if a concern was dismissed, the patient was not recovering, or emergency systems were unreliable.