CDC Emergency Procedures & Response 3 — Questions and Answers
Question 1: A patient develops sudden chest pain, diaphoresis, and jaw pain during a dental appointment. What is the most likely diagnosis?
- Hyperventilation syndrome
- Acute myocardial infarction (Correct answer)
- Vasovagal syncope
- Hypertensive crisis
Correct answer: Acute myocardial infarction
Chest pain with diaphoresis and jaw pain are classic signs of acute myocardial infarction requiring immediate 911 activation.
Question 2: Which position is most appropriate for a patient experiencing anaphylactic shock in the dental office?
- Semi-reclined at 45 degrees
- Supine with legs elevated (Trendelenburg) (Correct answer)
- Upright sitting
- Recovery position on their side
Correct answer: Supine with legs elevated (Trendelenburg)
Supine position with legs elevated increases venous return and maintains cerebral perfusion in anaphylactic shock.
Question 3: During administration of local anesthesia, a patient reports ringing in the ears and a metallic taste. These are signs of:
- Allergic reaction to preservatives
- Local anesthetic systemic toxicity (LAST) (Correct answer)
- Vasovagal syncope
- Hypertensive emergency
Correct answer: Local anesthetic systemic toxicity (LAST)
Tinnitus and metallic taste are early CNS warning signs of local anesthetic systemic toxicity due to elevated plasma drug levels.
Question 4: A patient with asthma experiences bronchospasm in the dental chair unrelieved by their own inhaler. What is the next step?
- Administer oral prednisone
- Administer epinephrine 1:1,000 IM and activate EMS (Correct answer)
- Give the patient another dose of their inhaler
- Administer IV diphenhydramine
Correct answer: Administer epinephrine 1:1,000 IM and activate EMS
Severe bronchospasm unresponsive to the patient's own bronchodilator requires IM epinephrine and immediate EMS activation.
Question 5: An automated external defibrillator (AED) analyzes a rhythm and advises 'no shock recommended.' What should the responder do?
- Charge the AED manually and shock anyway
- Immediately resume CPR (Correct answer)
- Check for a pulse and call 911 if not done
- Attach a second set of pads
Correct answer: Immediately resume CPR
When the AED advises no shock, CPR should be resumed immediately as the rhythm may be a non-shockable arrest (PEA or asystole).
Question 6: A patient experiences a tonic-clonic seizure lasting more than 5 minutes. This condition is called:
- Absence status
- Status epilepticus (Correct answer)
- Simple partial seizure
- Todd's paralysis
Correct answer: Status epilepticus
Status epilepticus is defined as a seizure lasting 5 minutes or more and is a medical emergency requiring immediate EMS.
Question 7: Which emergency drug in the dental office is used to reverse opioid-induced respiratory depression?
- Flumazenil
- Naloxone (Narcan) (Correct answer)
- Physostigmine
- Atropine
Correct answer: Naloxone (Narcan)
Naloxone (Narcan) is a competitive opioid antagonist that rapidly reverses respiratory depression caused by opioid medications.
CDC Emergency Procedures & Response 3
A patient develops sudden chest pain, diaphoresis, and jaw pain during a dental appointment.
What is the most likely diagnosis?