RDA Recognition and Management of Medical Emergencies 4 — Questions and Answers
Question 1: A patient suddenly becomes unresponsive and has no pulse. What is the correct compression-to-ventilation ratio for adult CPR performed by two rescuers?
- 15:2
- 30:2 (Correct answer)
- 15:1
- 30:1
Correct answer: 30:2
The AHA recommends a 30:2 compression-to-ventilation ratio for adult CPR regardless of whether one or two rescuers are present.
Question 2: Which of the following is the MOST common cause of syncope in the dental office?
- Hypoglycemia
- Anaphylaxis
- Vasovagal response (Correct answer)
- Hyperventilation
Correct answer: Vasovagal response
Vasovagal syncope (neurally mediated fainting) triggered by anxiety, pain, or fear is the most frequent medical emergency in dental settings.
Question 3: A patient with a known peanut allergy develops generalized urticaria, throat tightness, and hypotension after administration of a local anesthetic. What is the first-line treatment?
- Oral diphenhydramine
- Intramuscular epinephrine 1:1000 (Correct answer)
- Intravenous corticosteroids
- Sublingual nitroglycerin
Correct answer: Intramuscular epinephrine 1:1000
Intramuscular epinephrine 1:1000 (0.3 mg in adults) into the anterolateral thigh is the first-line treatment for anaphylaxis.
Question 4: During a procedure, a patient with a history of asthma begins wheezing and has difficulty breathing. After stopping the procedure, the NEXT step is to:
- Administer oxygen via nasal cannula at 2 L/min
- Have the patient use their bronchodilator inhaler (Correct answer)
- Call 911 immediately
- Place the patient in Trendelenburg position
Correct answer: Have the patient use their bronchodilator inhaler
For a mild to moderate asthma attack in a conscious patient, the immediate step is to administer the patient's own bronchodilator (rescue inhaler).
Question 5: A diabetic patient becomes pale, diaphoretic, and confused midway through treatment. Blood glucose is unavailable. The MOST appropriate initial action is to:
- Administer glucagon intramuscularly
- Give oral glucose such as orange juice or glucose gel (Correct answer)
- Place the patient supine and monitor
- Call 911 and wait for EMS
Correct answer: Give oral glucose such as orange juice or glucose gel
For a conscious hypoglycemic patient, oral carbohydrates (orange juice, glucose gel, candy) should be given immediately to raise blood sugar.
Question 6: Which position is MOST appropriate for a patient experiencing an acute asthmatic episode in the dental chair?
- Supine (flat)
- Trendelenburg (feet elevated)
- Upright or semi-reclined (Correct answer)
- Left lateral decubent
Correct answer: Upright or semi-reclined
An upright or semi-reclined position eases breathing by reducing pressure on the diaphragm and improving lung expansion during an asthma attack.
Question 7: A patient reports crushing chest pain radiating to the left arm and jaw. Nitroglycerin is administered sublingually but pain persists after 5 minutes. What is the correct next step?
- Administer a second nitroglycerin tablet and wait another 10 minutes
- Activate EMS (call 911) immediately (Correct answer)
- Have the patient chew an aspirin tablet
- Administer oxygen and recheck in 5 minutes
Correct answer: Activate EMS (call 911) immediately
If chest pain persists after one nitroglycerin dose, EMS must be activated immediately as this indicates a likely myocardial infarction.
RDA Recognition and Management of Medical Emergencies 4
A patient suddenly becomes unresponsive and has no pulse.
What is the correct compression-to-ventilation ratio for adult CPR performed by two rescuers?