ORE Part 2 NHS Dental Contracts & Medical Emergencies 2 — Questions and Answers
Question 1: What is the Resuscitation Council recommended ratio of chest compressions to rescue breaths in adult CPR?
- 30 compressions to 2 rescue breaths (30:2) (Correct answer)
- 15:2
- 5:1
- Compressions only — no rescue breaths
Correct answer: 30 compressions to 2 rescue breaths (30:2)
The Resuscitation Council UK guidelines recommend a 30:2 ratio of chest compressions to rescue breaths for adult CPR by trained responders, prioritising high-quality chest compressions.
Question 2: What is the correct management of a faint (vasovagal syncope) in the dental chair?
- Lower the chair (supine position), elevate legs, loosen tight clothing, ensure airway is open, monitor recovery (Correct answer)
- Give oral glucose immediately
- Administer IM adrenaline
- Call 999 for all faints
Correct answer: Lower the chair (supine position), elevate legs, loosen tight clothing, ensure airway is open, monitor recovery
Vasovagal syncope is managed by lying the patient flat with legs elevated to restore cerebral perfusion; most patients recover quickly without medication.
Question 3: Which drug reverses the effects of benzodiazepine oversedation in conscious sedation emergencies?
- Flumazenil (Correct answer)
- Naloxone
- Glucagon
- Midazolam itself at higher dose
Correct answer: Flumazenil
Flumazenil is the specific benzodiazepine receptor antagonist that reverses benzodiazepine-induced sedation and respiratory depression, used in sedation emergencies.
Question 4: What is the minimum oxygen supply requirement for a dental practice according to emergency guidelines?
- Portable oxygen cylinder sufficient for 30 minutes of flow (minimum 1,000 litres) (Correct answer)
- Piped oxygen from the mains
- 500 litre cylinder
- No minimum — size is not specified
Correct answer: Portable oxygen cylinder sufficient for 30 minutes of flow (minimum 1,000 litres)
Resuscitation Council UK guidelines recommend a minimum oxygen supply of at least 1,000 litres (approximately 30 minutes at 10 L/min) to sustain emergency treatment until ambulance arrival.
Question 5: What is the correct inhaled dose of salbutamol for an acute mild-to-moderate asthma attack?
- 2–10 puffs of 100 mcg salbutamol via spacer (Correct answer)
- One puff only
- Nebulised only — inhaler not appropriate
- 2 mg oral tablet
Correct answer: 2–10 puffs of 100 mcg salbutamol via spacer
For mild-to-moderate acute asthma in the dental surgery, 2–10 puffs of salbutamol (100 mcg per puff) via a spacer device are recommended, allowing reassessment between administrations.
Question 6: What are the signs of a hypoadrenal (Addisonian) crisis in the dental surgery?
- Profound hypotension, collapse, confusion, pallor, and nausea in a patient on long-term steroids (Correct answer)
- Hypertension and agitation
- Only mild dizziness
- Chest pain and bradycardia
Correct answer: Profound hypotension, collapse, confusion, pallor, and nausea in a patient on long-term steroids
Addisonian crisis (acute adrenocortical insufficiency) presents with severe hypotension, collapse, confusion, and pallor, typically in patients on long-term corticosteroids who have not been steroid-covered.
ORE Part 2 NHS Dental Contracts & Medical Emergencies 2
What is the Resuscitation Council recommended ratio of chest compressions to rescue breaths in adult CPR?