ADEX Management of Medical Emergencies 2 — Questions and Answers
Question 1: A patient begins experiencing an asthma attack during a dental procedure. After stopping treatment, what is the FIRST action the dental hygienist should take?
- Administer epinephrine intramuscularly
- Have the patient use their bronchodilator inhaler (Correct answer)
- Place the patient in the supine position
- Call 911 immediately
Correct answer: Have the patient use their bronchodilator inhaler
The first step in managing an acute asthma attack is to have the patient self-administer their prescribed bronchodilator (rescue inhaler) while placed in an upright position.
Question 2: Which of the following best describes the signs of hypoglycemia in a dental patient?
- Dry skin, fruity breath, and slow onset
- Diaphoresis, confusion, and shakiness with rapid onset (Correct answer)
- Hypertension, bradycardia, and facial flushing
- Cyanosis, wheezing, and urticaria
Correct answer: Diaphoresis, confusion, and shakiness with rapid onset
Hypoglycemia presents with diaphoresis (sweating), confusion, and trembling due to rapid blood glucose drop, distinguishing it from hyperglycemia which has a slower onset.
Question 3: A patient with a known peanut allergy develops hives, itching, and swelling of the lips shortly after a procedure. The dental hygienist suspects anaphylaxis is developing. What is the drug of choice?
- Diphenhydramine (Benadryl) IV
- Epinephrine 1:1000 IM into the anterolateral thigh (Correct answer)
- Methylprednisolone IV bolus
- Albuterol via nebulizer
Correct answer: Epinephrine 1:1000 IM into the anterolateral thigh
Epinephrine 1:1000 administered intramuscularly into the anterolateral thigh is the first-line treatment for anaphylaxis due to its rapid alpha and beta adrenergic effects.
Question 4: During a dental appointment, a patient suddenly loses consciousness and has no pulse. In what ratio should compressions to ventilations be performed for adult CPR by two rescuers?
- 15:2
- 30:2 (Correct answer)
- 15:1
- 30:1
Correct answer: 30:2
Current AHA guidelines recommend a 30:2 compression-to-ventilation ratio for adult CPR with two rescuers, ensuring adequate chest compressions with minimal interruptions.
Question 5: A patient with a history of angina reports chest pain that is not relieved after one nitroglycerin tablet. What is the appropriate next step?
- Administer a second nitroglycerin tablet and wait 10 minutes
- Administer a second nitroglycerin tablet after 5 minutes and call EMS if pain persists after a third dose (Correct answer)
- Place the patient supine and call 911 immediately
- Give aspirin 325 mg and monitor for 30 minutes
Correct answer: Administer a second nitroglycerin tablet after 5 minutes and call EMS if pain persists after a third dose
If one nitroglycerin tablet does not relieve chest pain, a second may be given after 5 minutes; if pain persists after a third dose, EMS must be activated as myocardial infarction is suspected.
Question 6: Which position is MOST appropriate for a patient experiencing syncope in the dental chair?
- Seated upright with head between knees
- Supine with legs elevated above heart level (Trendelenburg) (Correct answer)
- Semi-reclined at 45 degrees
- Left lateral recumbent position
Correct answer: Supine with legs elevated above heart level (Trendelenburg)
The Trendelenburg position (supine with legs elevated) increases venous return to the heart and improves cerebral perfusion in patients experiencing vasovagal syncope.
Question 7: A patient taking warfarin presents with uncontrolled bleeding after a simple extraction. Which emergency drug found in the dental office emergency kit is MOST relevant?
- Epinephrine
- Nitroglycerin
- Glucose gel
- Vasoconstrictors are used topically; no systemic emergency drug is indicated (Correct answer)
Correct answer: Vasoconstrictors are used topically; no systemic emergency drug is indicated
For anticoagulant-induced prolonged bleeding, local hemostatic measures (pressure, gelatin sponge) are used; systemic reversal agents like vitamin K or FFP are not part of the dental emergency kit.
ADEX Management of Medical Emergencies 2
A patient begins experiencing an asthma attack during a dental procedure.
After stopping treatment, what is the FIRST action the dental hygienist should take?