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Dental mythbuster 4: Drugs and equipment for a medical emergency

Categories:
  • Organisations we regulate

Our priority is to carry out an assessment of the quality of primary care dental services. From this we make a judgement about whether they provide people with care that is safe, effective, caring, responsive and well-led, based on whether the regulations (including the fundamental standards) are being met.

Our inspectors consider drugs and equipment for a medical emergency when they review if the practice is safe. This relates to:

The medicines and equipment should be in an accessible and central location known to everyone.


Mandatory requirements

The GDC standards for the dental team state that, as a dental professional, you must follow the guidance on medical emergencies and training updates issued by the Resuscitation Council (UK).

We expect a practice to follow the national guidance issued by the Resuscitation Council. Immediate access to an automated external defibrillator (AED) in an emergency increases the chances of survival of the patient. Where an AED is not available, we expect to see a robust and realistic risk assessment detailing how an AED could be accessed in a timely manner. Emergency services may not always be able to respond in the critical first few minutes of an acute cardiac arrest.


Recommended practice

A practice could be in a difficult position from a medico-legal point of view if a patient came to harm during dental treatment due to the lack of emergency medicines and equipment listed below.

Professional guidelines: NICE: Prescribing in dental practice (Medical emergencies in dental practice)

  1. These should be available to manage the more common medical emergencies encountered in general dental practice:
    • adrenaline/epinephrine injection, adrenaline 1 in 1000, (adrenaline 1 mg/mL as acid tartrate), 1 mL amps
    • aspirin dispersible tablets 300 mg
    • glucagon injection, glucagon (as hydrochloride), 1- unit vial (with solvent)
    • glucose (for administration by mouth)
    • glyceryl trinitrate spray
    • midazolam oromucosal solution
    • oxygen
    • salbutamol aerosol inhalation, salbutamol 100 micrograms/ metered inhalation

Professional guidelines: Resuscitation Council UK quality standards for cardiopulmonary resuscitation and training

  1. The following is the minimum equipment recommended:
    • adhesive defibrillator pads
    • automated external defibrillator (AED)
    • clear face masks for self-inflating bag (sizes 0,1,2,3,4)
    • oropharyngeal airways sizes 0,1,2,3,4
    • oxygen cylinder
    • oxygen masks with reservoir
    • oxygen tubing
    • pocket mask with oxygen port
    • portable suction e.g. Yankauer
    • protective equipment – gloves, aprons, eye protection
    • razor
    • scissors
    • self-inflating bag with reservoir (adult)
    • self-inflating bag with reservoir (child)
  1. Oxygen cylinders should be easily portable but also allow adequate flow rates, for example 15 litres per minute, until an ambulance arrives or the patient fully recovers. Consider what size of cylinder to use and whether you need a second one in case the first is at risk of running out.
  1. Quality Assurance Process: Expiry dates for emergency medicines and equipment and availability of oxygen should be checked at least weekly.
Last updated:
27 November 2019

 


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