NHS Dental Contracts & Medical Emergencies Flashcards

What is the 'steroid cover' protocol for a dental patient on long-term oral corticosteroids (prednisolone ≥ 5 mg/day) undergoing a stressful extraction?

Answer: Continue usual dose; double the dose on day of procedure if on ≤ 10 mg/day; seek medical advice for complex cases

Current UK guidance advises continuing usual steroids; for minor procedures, no supplementation is needed for most; for major stressful procedures, medical advice should be sought; the previous routine doubling protocol is evolving based on evidence.

What is the management of an epileptic seizure in a dental surgery?

Answer: Protect from injury, time the seizure, do not restrain, call 999 if >5 min, give buccal midazolam if available and prolonged

During seizures: protect from injury (clear the area), time the duration, do not restrain or insert anything in the mouth, call 999 if >5 minutes, and administer buccal midazolam if available and the seizure is prolonged.

What is the difference between Type 1 and Type 2 respiratory failure in the context of a dental emergency?

Answer: Type 1: hypoxaemia with normal CO2 (e.g., acute asthma); Type 2: hypoxaemia with raised CO2 (e.g., COPD)

Type 1 respiratory failure (low O2, normal CO2) occurs in conditions like acute asthma; Type 2 (low O2, high CO2) occurs in COPD exacerbations — management differs, particularly oxygen dose in COPD.

What should be documented following a medical emergency in the dental practice?

Answer: Full contemporaneous record: time, events, vital signs, drugs given, doses, personnel, outcome, and referral

A full record of the medical emergency must be made contemporaneously, including timeline, all treatments, drugs with doses and routes, personnel present, patient response, and any referral or ambulance called.

What is the recommended depth of chest compressions in adult CPR?

Answer: 5–6 cm at a rate of 100–120 per minute

Resuscitation Council UK guidelines specify chest compressions of 5–6 cm depth at a rate of 100–120 per minute, allowing full chest recoil between compressions.

What is the purpose of an automated external defibrillator (AED) and when should it be used?

Answer: Delivers an electric shock to restore normal rhythm in ventricular fibrillation or pulseless VT — use as soon as available

AEDs analyse cardiac rhythm and deliver a shock for shockable rhythms (VF/pulseless VT); they should be applied and used as soon as available during cardiac arrest, as early defibrillation dramatically improves survival.