ORE Part 2 NHS Dental Contracts & Medical Emergencies 3

Question 1

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

Accepted Answer

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

Answer

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.

Question 2

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

Accepted Answer

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

Answer

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.

Question 3

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

Accepted Answer

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

Answer

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.

Question 4

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

Accepted Answer

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

Answer

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.

Question 5

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

Accepted Answer

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

Answer

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.

ORE Part 2 Practice Test

ORE Part 2 Practice Test

ORE Part 2 NHS Dental Contracts & Medical Emergencies 3