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Kishimoto N, Ujita T, Tran SD, Sanuki T, Seo K. Simulation training for medical emergencies: Evaluation of dentists' long-term learning skills and confidence. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:689-697. [PMID: 38379393 DOI: 10.1111/eje.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/31/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION As the population ages and more patients experience medical emergencies during dental treatments, dentists must competently and confidently manage these situations. We developed a simulation training course for medical emergencies in the dental setting using an inexpensive vital sign simulation app for smartphones/tablets without the need for an expensive simulator. However, the duration for which this effect is maintained is unclear. This study was performed to evaluate the long-term educational effect at 3, 6, and 12 months after taking the course. MATERIALS AND METHODS Thirty-nine dental residents participated in this course. Scenarios included vasovagal syncope, anaphylaxis, hyperventilation syndrome, and acute coronary syndrome, each of which the participants had to diagnose and treat. The participants were evaluated using a checklist for anaphylaxis diagnosis and treatment skills immediately after and 3, 6, and 12 months after the course. The participants were also surveyed about their confidence in diagnosing and treating these conditions by questionnaire before, immediately after, and 3, 6, and 12 months after the course. RESULTS The checklist scores for anaphylaxis were significantly lower at 3, 6, and 12 months after the course than immediately after the course. The percentage of participants who provided a correct diagnosis and appropriate treatment for vasovagal syncope, hyperventilation syndrome, and acute coronary syndrome was lower at all reassessments than immediately after the course. CONCLUSION Because medical emergency management skills and confidence declined within 3 months, it would be useful to introduce a refresher course approximately 3 months after the initial course to maintain skills and confidence.
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Affiliation(s)
- Naotaka Kishimoto
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tomoaki Ujita
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Simon D Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Kenji Seo
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Al-Sebaei MO. Frequency and features of medical emergencies at a teaching dental hospital in Saudi Arabia: a 14-year retrospective observational study. BMC Emerg Med 2024; 24:41. [PMID: 38475693 PMCID: PMC10935771 DOI: 10.1186/s12873-024-00957-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND This study aimed to determine the nature, frequency, and characteristics of medical emergencies occurring at the King Abdulaziz University Dental Hospital. MATERIALS AND METHODS The incident reports of medical emergencies recorded at the King Abdulaziz University Dental Hospital from January 2008 to December 2022 were retrospectively reviewed. The annual/overall incidence of medical emergency events was calculated per 100,000 patients. The following characteristics of the patients/events were evaluated: age, gender, operator, procedure, location, timing of treatment, administration of local anesthesia, past medical history, symptoms, diagnosis, outcome, and disposition. Multivariable logistic regression models were used to investigate the associations of these characteristics with two outcomes: syncope and transfer to the emergency room (ER). RESULTS The incidence of emergency events was 17.4 per 100,000 patients. Syncope and hypoglycemia were the most common emergencies. Most incidents recovered, with only 13% requiring transfer to the ER. Undergoing no procedure and American Society of Anesthesiologists (ASA) class 2,3 were associated with syncope. Undergoing a general dental procedure, ASA class 2,3, and a diagnosis other than hypoglycemia and syncope were associated with transfer to the ER. CONCLUSIONS The incidence of medical emergencies was low. Dental practitioners need to remain aware of the contributing factors, such as past medical history and anxiety, but medical emergencies can occur in healthy individuals as well. Preparation of the dental office, training of the personnel, and proper recording of the events are essential components of a well-established medical emergency protocol in dental institutions.
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Affiliation(s)
- Maisa O Al-Sebaei
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University - Faculty of Dentistry, 21589, Jeddah, PO Box 80209, Saudi Arabia.
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Queirolo L, Facco E, Bacci C, Mucignat C, Zanette G. Impairment of Hypnosis by Nocebo Response and Related Neurovegetative Changes: A Case Report in Oral Surgery. Int J Clin Exp Hypn 2024:1-13. [PMID: 38363817 DOI: 10.1080/00207144.2024.2311908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/20/2023] [Indexed: 02/18/2024]
Abstract
This article presents the third molar removal in a highly hypnotizable patient, who had been successfully submitted to oral surgery with hypnosis as stand-alone anesthesia in previous sessions. Unexpectedly, hypnosis initially failed, as a result of a nocebo response due to a previous dentist's bad communication; two complaints made by the patient were associated with increased sympathetic activity (as defined by increased heart rate and electrodermal activity and decreased heart rate variability). After deepening of hypnosis, the patient achieved a full hypnotic analgesia allowing for a successful conclusion of the intervention, an event associated with decreased heart rate, electrodermal activity, and increased heart rate variability. Hence, the initial failure was paralleled by a decreased parasympathetic activity and increased sympathetic activity, while hypnotic analgesia was associated with the opposite pattern. The patient's postoperative report indicated that the initial failure of hypnosis depended on a strong nocebo effect because of a previous dentist distrusting hypnosis and persuading her that it was not enough to face a third molar removal.
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Affiliation(s)
- Luca Queirolo
- Department of Neurosciences, Section of Clinical Dentistry, University of Padova, Italy
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Italy
| | - Enrico Facco
- Department of Neurosciences, Section of Clinical Dentistry, University of Padova, Italy
- Institution Franco Granone-Italian Center for Clinical and Experimental Hypnosis, Turin, Italy
| | - Christian Bacci
- Department of Neurosciences, Section of Clinical Dentistry, University of Padova, Italy
| | - Carla Mucignat
- Department of Neurosciences, Section of Clinical Dentistry, University of Padova, Italy
- Department of Molecular Medicine, University of Padova, Italy
| | - Gastone Zanette
- Department of Neurosciences, Section of Clinical Dentistry, University of Padova, Italy
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Wiggin C, McColl E. Top tips for managing medical emergencies in primary care. Br Dent J 2024; 236:14-17. [PMID: 38225296 DOI: 10.1038/s41415-024-6749-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Affiliation(s)
- Christian Wiggin
- Critical Care Paramedic and Director of Crux Medical, Exeter, Devon, UK.
| | - Ewen McColl
- Head of School/Director of Clinical Dentistry, Peninsula Dental School (University of Plymouth), Derriford Dental Education Facility, Plymouth Science Park, Research Way, Plymouth, PL6 8BT, UK.
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Kishimoto N, Sanuki T, Liu Y, Tran SD, Seo K. Simulation training for medical emergencies of dental patients: A review of the dental literature. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:104-113. [PMID: 36937224 PMCID: PMC10017307 DOI: 10.1016/j.jdsr.2023.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023] Open
Abstract
In recent years, due to the aging of the population, the number of dental patients with comorbidities such as hypertension and diabetes has increased. Although it has been reported that these patients are increasingly developing medical emergencies during their dental treatments, many dental providers still do not possess the skills to manage medical emergencies appropriately. Simulation training is essential to improve this situation however, there is no report describing how to conduct an effective simulation in detail for dental office medical emergencies. The purpose of this review is to provide information on simulations that is effective and practical. The authors will highlight the key characteristics for providing effective simulation trainings, such as the selection of simulators, simulation locations, instructors, debriefings, methods for evaluating educational effectiveness, and the use of telesimulation as a method for simulation training due to the global COVID-19 pandemic. In addition, this review provides recommendations on tailoring an ideal simulation training course for those who wish to create one. The authors hope that this review will promote the spread of effective simulation training and in turn, contribute to improving the medical safety of dental patients.
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Affiliation(s)
- Naotaka Kishimoto
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Corresponding author at: Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, 2-5274, Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.
| | - Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Younan Liu
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - Kenji Seo
- Division of Dental Anesthesiology, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Sin M, Edwards D, Currie C, Corbett I. Prevalence of medical emergency events in primary dental care within the UK. Br Dent J 2023; 235:721-726. [PMID: 37945869 PMCID: PMC10635819 DOI: 10.1038/s41415-023-6444-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 11/12/2023]
Abstract
Introduction Dental professionals have an ethical and legal obligation to diagnose and manage medical emergencies which may occur in primary dental care.Aims and objectives To investigate the prevalence of medical emergencies in UK primary dental care and explore the medical emergency training needs of UK primary dental care professionals.Design and setting Cross-sectional survey, targeting dentists, dental hygienists and dental therapists across the UK working within primary dental care.Materials and methods An online survey was distributed via dental society mailing lists, social media groups and a dental conference. The questionnaire consisted of participants demographics and training in, prevalence of and confidence surrounding medical emergencies.Results Respondents (n = 400) were dentists (55.8%), dental hygienists/therapists (38.8%) and specialists (5.5%). Most participants received basic life support training (62%) in 2019, before COVID-19. The most common medical emergencies were syncope, non-specific collapse and hypoglycaemia, being encountered every 1.59, 1.64 and 8.26 years, respectively. The preferred method for medical emergency training was practical based, with more training in administering emergency drugs and equipment identified as a training need.Conclusion Dental professionals will encounter medical emergencies in primary dental care every 1-2 years and are therefore not uncommon.
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Affiliation(s)
- Melissa Sin
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK
| | - David Edwards
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK.
| | - Charlotte Currie
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK
| | - Ian Corbett
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK
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Gupta S, Mishra S, Behl S, Srikant N, Mascarenhas R. Knowledge of handling medical emergencies among general dental practitioners pan India: a cross-sectional survery. BMC Res Notes 2023; 16:221. [PMID: 37710327 PMCID: PMC10503061 DOI: 10.1186/s13104-023-06477-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 08/25/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Medical emergency situations in dental clinics have been contemplated to be an issue in most of the countries by reason of dentist's lack of knowledge and preparedness to attend emergency situations in dental offices. The aim of this paper is to observe the knowledge, attitude, and perceived confidence of the general dental practitioners regarding emergency medical care and its practical application. Questionnaire on knowledge assessment was circulated among 500 dentists using printed questionnaire formats and various social media platforms. The questionnaire included details on treating hypertensive patients, cardiopulmonary resuscitation training, accessibility of medical emergency equipments in the dental clinics, prevalence of medical emergency cases in the dental office and the self-assessed competence to handle medical emergency situations in the dental clinics. Data was surveyed and scrutinized using the Statistical Package for Social Sciences (SPSS), version 17 (SPSS Inc., Chicago IL). Descriptive statistics was tabulated and Chi square tests was applied. FINDINGS 500 general dental practitioners pan India were involved in the study (294 were females and 207 were males). They were grouped into different age groups (20-30 yrs, 30-40 yrs, 40-50 yrs, 50 and above) and experience (0-5 yrs, 5-10 yrs and more than 10 years). 279 participants did not attend any medical emergency training whereas, 222 participants from all groups attended training program. It was observed that with increased experience in the field, the knowledge, awareness and confidence to treat medical emergency situation in the dental clinics was better. Dentists should update themselves from time-to-time with the latest technologies in the field and need to attend training programs to handle any medical emergency situations in the dental offices. Medical emergencies in a dental clinic can be encountered at any point of time and the clinician should have apt knowledge in handling such situations. Majority of the dentists feel subdued in managing medical situations in dental offices. Training and workshops for handling medical situations in the dental offices should be mandated at the undergraduate and postgraduate levels. This will help the dentist to shape one's confidence in managing such situations without apprehension. Availability of proper infrastructure and equipments is recommended in every dental clinics so as to ease the handling of the situation. CONCLUSION This paper enlightens the need of basic life support training on regular basis among the dentists to improve the competence among them and to improve the confidence in handling such situations.
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Affiliation(s)
- Shubhangi Gupta
- Department of Oral and Maxillofacial Surgery, Sri Dharmasthala, Manjuatheswara College of Dental Sciences, Dharwad, India
| | - Stuti Mishra
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Shubhangi Behl
- Department of Periodontolgy, Bharati Vidyapeeth Dental College and Hospital, Pune, India
| | - N Srikant
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore Affliliated to Manipal Academy of Higher Education, Manipal, India
| | - Roma Mascarenhas
- Department of Prosthodontics and Crown and Bridge, Manipal College of Dental Sciences, Manipal, Karnataka, India.
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore Affliliated to Manipal Academy of Higher Education, Manipal, India.
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Hasnain S, Hussan J, Khan L, Muhammad S, Kamal K, Sawaira, Hayat U, Abbasi A, Akhlaq M, Ahmad A, Ahmad K. Factors affecting knowledge and attitude of healthcare workers towards basic life support in Khyber Teaching Hospital, Peshawar, Pakistan: a cross-sectional analysis. BMJ Open 2023; 13:e073369. [PMID: 37666556 PMCID: PMC10481732 DOI: 10.1136/bmjopen-2023-073369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVE This study was conducted to assess the knowledge and attitude of healthcare workers towards basic life support (BLS) in Khyber Teaching Hospital, Peshawar, and to investigate the factors affecting them. DESIGN Cross-sectional study. SETTING This study was carried out in a tertiary care hospital in Peshawar, Pakistan. PARTICIPANTS 201 healthcare professionals were recruited for this study through simple convenience sampling which included house officers (HOs), trained medical officers, postgraduate residents, professors, specialty registrars and nurses. Healthcare professionals who were reluctant to give consent were excluded from the study. RESULTS Among the chosen participants, only 16.4% had good knowledge whereas 63% had a good attitude towards BLS. Knowledge of participants was found to be positively associated with less time elapsed between the training sessions (p=0.041). On the other hand, factors such as age(p=0.004), designation (p=0.05), number of BLS sessions attended (p=0.012) and the time elapsed since the last BLS session attended (p=0.015), were positively associated with the attitude of healthcare professionals. CONCLUSION The level of knowledge and attitude towards BLS by healthcare professionals was suboptimal. Those individuals who had attended BLS training sessions frequently had better knowledge and attitude as compared with their counterparts.
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Affiliation(s)
| | - Jehan Hussan
- Community Medicine, Khyber Medical College, Peshawar, Pakistan
| | - Laiba Khan
- Student, Khyber Medical College, Peshawar, Pakistan
| | | | - Khkula Kamal
- Student, Khyber Medical College, Peshawar, Pakistan
| | - Sawaira
- Student, Khyber Medical College, Peshawar, Pakistan
| | - Umair Hayat
- Student, Khyber Medical College, Peshawar, Pakistan
| | - Areej Abbasi
- Student, Khyber Medical College, Peshawar, Pakistan
| | | | - Ali Ahmad
- Student, Khyber Medical College, Peshawar, Pakistan
| | - Khizar Ahmad
- Student, Khyber Medical College, Peshawar, Pakistan
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Choi E, Lee YH, Park HK. Orofacial Pain with Cardiac Origin of Coronary Artery Disease: A Case Report and Literature Review. Case Rep Dent 2023; 2023:6304637. [PMID: 37475834 PMCID: PMC10356533 DOI: 10.1155/2023/6304637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
When diagnosing orofacial pain, clinicians should also consider non-odontogenic origin and systemic diseases as possible etiological factors, along with odontogenic origin. This case report aimed to provide information for early detection of orofacial pain of cardiac origin by dentists, when pain due to coronary artery disease is the only presenting symptom. A 60-year-old male patient with unexplained isolated bilateral jaw pain that had persisted for the past 5 years was referred to a dentist by an anesthesiologist who suspected temporomandibular joint disorder. In oral examination, no specific pathological changes were observed in the oral cavity, including teeth, surrounding alveolar bone, and buccal mucosa. Magnetic resonance imaging and conventional radiography showed no pathological destruction or abnormalities of bone and soft tissue in the temporomandibular joint region. However, pain was precipitated by ordinary daily activities, and the pain alleviating factor was rest. Eventually, the patient was referred to a cardiologist for further evaluation since his pain was induced by physical activity. Coronary artery disease (CAD) was diagnosed using coronary computed tomography angiography, and the pain was considered to be angina pectoris. Percutaneous coronary intervention was successfully done for the patient, after which his orofacial symptoms disappeared. To conclude, isolated craniofacial pain of cardiac origin may lead to patients seeking dental care or visiting orofacial pain clinics. In these settings, dentists and orofacial pain specialists may contribute to the diagnosis of CAD and refer patients for cardiac evaluation and appropriate management.
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Affiliation(s)
- Eunhye Choi
- Dental Research Institute, Seoul National University School of Dentistry, Seoul 03080, Republic of Korea
- Department of Oral Medicine and Oral Diagnosis, Bucheon Apple Tree Dental Hospital, 20, Bucheon-ro, Bucheon-si, Gyeonggi-do, Republic of Korea
| | - Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Kyung Hee University School of Dentistry, #613 Hoegi-dong, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, Dental Research Institute, Seoul National University School of Dentistry, Seoul 03080, Republic of Korea
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Shaath H, Salman B, Daghistani D, Koutaich R, Alhammadi A, Yakoub N, Awad MA. A Pilot Study of Preparedness of Dentists in the United Arab Emirates to Deal with Medical Emergencies. Eur J Dent 2023; 17:749-755. [PMID: 37059445 PMCID: PMC10569866 DOI: 10.1055/s-0042-1755628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVES The purpose of this pilot study is to assess the United Arab Emirates dentists' preparedness to manage medical emergencies. MATERIALS AND METHODS Ninety-seven licensed dentists participated in this study. Dentists responded to self-administrated questionnaires that contained 23 questions divided into five parts. The first part collected data on participants' sex, years of experience, and whether they are general dental practitioner (GDP) or specialists. The second part included seven questions that asked participants to indicate if they took medical history, obtained vital signs, and attended basic life support courses. The third part included six multiple choice questions regarding the availability of emergency drugs in the dental clinic. The fourth part consisted of three multiple-choice questions that assessed the dentists' immediate response to a medical emergency. Finally, the fifth part comprised four questions to evaluate the dentists' knowledge of proper treatment of special emergency cases they may encounter in the dental offices. RESULTS Out of the 97 participants, only 51% (N = 49) indicated that they can handle emergencies such as anaphylactic shock and syncope in the dental office. The majority of the dentists (80%) indicated that they have emergency kits. Only 46% of the specialists and 42% of the GDPs were able to correctly plan extractions in a patient with a prosthetic heart valve. Less than half of the participants (N = 35, 36%) were able to correctly answer the question regarding management of a foreign-body aspiration by attempting Heimlich/Triple maneuver. CONCLUSIONS Within the limitations of this study, dentists need further hands-on training to improve their skills and knowledge about medical emergencies that could occur in the dental settings. Furthermore, we recommend that guidelines should be available in the clinic to strengthen the dentists' ability to deal with medical emergencies.
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Affiliation(s)
- Helmi Shaath
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Basheer Salman
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Dalia Daghistani
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Rayan Koutaich
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Alya Alhammadi
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Nermeen Yakoub
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
| | - Manal A. Awad
- College of Dental Medicine, Department of Preventive and Restorative Dentistry, University of Sharjah, Sharjah, United Arab Emirates
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Aljuwaybiri R, Almekhlafi FA, Alzahrani RM, Almehmadi RT, Alsubhi MY, Alruwais AT, Shatla MM. Knowledge and Awareness of Syncope Among General Populations of Makkah Region in Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e38276. [PMID: 37255886 PMCID: PMC10226007 DOI: 10.7759/cureus.38276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 06/01/2023] Open
Abstract
Background Syncope is a transient loss of consciousness and postural tone due to global cerebral hypoperfusion which is followed by spontaneous recovery. It is relatively common and increases the risk of subsequent falls and injury. There is scant literature and targeted research on the population's knowledge of syncope. Hence, this study aimed to assess awareness and evaluate the knowledge of syncope among the population of the Makkah region. Methodology An online cross-sectional study was done on 563 participants. A questionnaire was used to collect data about participants' demographics, experiencing syncope in relatives, and knowledge about syncope using case scenarios. Results Females represented 72.6% of the participants and about one third of participants admitted that they had experienced syncope throughout their life. About one-third of participants admitted that they had experienced syncope throughout their life. Most of the study participants (68.9%) showed a good level of knowledge about syncope while 31.1% of them had poor knowledge; the average awareness score was 5.3±1.64. Cardiogenic syncope was the most commonly recognized type of syncope. Furthermore, participants aged between 18 and 35 years and widowed participants demonstrated a good amount of knowledge about syncopal attacks (p<0.001). Conclusions General population of the Makkah region in Saudi Arabia had a sufficient level of knowledge about syncope. Additional studies along with educational programs are needed.
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Affiliation(s)
- Rawan Aljuwaybiri
- Medicine and Surgery, Umm Al-Qura University College of Medicine, Makkah, SAU
| | - Fatima A Almekhlafi
- Medicine and Surgery, Umm Al-Qura University College of Medicine, Makkah, SAU
| | - Rawan M Alzahrani
- Medicine and Surgery, Umm Al-Qura University College of Medicine, Makkah, SAU
| | - Reham T Almehmadi
- Medicine and Surgery, Umm Al-Qura University College of Medicine, Makkah, SAU
| | - Marwah Y Alsubhi
- Medicine and Surgery, Umm Al-Qura University College of Medicine, Makkah, SAU
| | - Asayel T Alruwais
- Medicine and Surgery, Umm Al-Qura University College of Medicine, Makkah, SAU
| | - Mokhtar M Shatla
- Family and Community Medicine, Umm Al-Qura University College of Medicine, Makkah, SAU
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Varoni EM, Rigoni M, Lodi G, Sardella A, Muti P, Vitello A, Montebugnoli L, Polimeni A, Tommasino S, Iriti M, Senna A, Iandolo R, Nisio A, Carrassi A. Medical emergencies in dental practice: A nationwide web-based survey of Italian dentists. Heliyon 2023; 9:e13910. [PMID: 36915515 PMCID: PMC10006528 DOI: 10.1016/j.heliyon.2023.e13910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
Objective Dentists must be prepared to manage medical emergencies, which are arisen during dental practice together with the increase of age population and medically compromised patients. This study aims at assessing the occurrence of medical emergencies in a cohort of Italian dentists, to ascertain their level of confidence in the management of these conditions, also based on their educational training and type of medical graduation, and, finally, to know their educational needs, in order to plan appropriate institutional interventions for specific training. Methods A national-based cross-sectional study was carried out by means of an online survey sent to all dentists working in Italy. Results The survey included 6818 questionnaires. Most of the respondents (n = 4443; 65.2%) reported the occurrence of at least one medical emergency during their professional life. The events rarely resulted in death as declared by only 62 (0.9%) of respondents. The commonest medical emergency was the vasovagal syndrome. Most medical emergencies occurred during the dental procedure (n = 4883; 71.6%). An average degree of satisfaction about the ability to diagnose and manage medical emergencies was reported by most of respondents, with high level of confidence in treating vasovagal syndrome, while a lack in preparedness about the management of myocardial infarction or transient ischemic attack (TIA) and stroke. Medical doctors were more confident in managing the emergencies than dentistry graduates (p < .01). Considering the educational needs, almost all of participants (n = 6721; 98.6%) declared the need to improve their training and expressed their interest in theoretical-practical institutional courses as well as in the establishment of an official national register for medical emergencies occurred in dental practice. Conclusions Medical emergencies are not negligible and the dentist should receive adequate training and continuing education to be updated and ready for their correct management. Clinical significance The dentist should be ready to deal with medical emergencies and provide first aid to the patient. The dentist is not always prepared to manage the most complex emergencies; therefore, there is the need to organize post-graduate courses and to set up an emergency register.
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Affiliation(s)
- Elena M Varoni
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Milan, Italy
| | - Marta Rigoni
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giovanni Lodi
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Milan, Italy
| | - Andrea Sardella
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Milan, Italy
| | - Paola Muti
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Antonio Vitello
- ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Milan, Italy
| | - Lucio Montebugnoli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Antonella Polimeni
- Dipartimento di Scienze Odontostomatologiche e Maxillo-Facciali, Università La Sapienza, Roma, Italy
| | - Stella Tommasino
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Milan, Italy
| | - Marcello Iriti
- Dipartimento di Scienze Agrarie e Ambientali, Università degli Studi di Milano, Milan, Italy
| | - Andrea Senna
- Italian National Commission of the Dental Board, Italy
| | | | | | - Antonio Carrassi
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Milan, Italy.,ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Milan, Italy
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13
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Cross sectional study on the competence and confidence of dental students and graduates in the management of medically compromised patients and acute medical emergencies. PLoS One 2023; 18:e0281801. [PMID: 36791139 PMCID: PMC9931094 DOI: 10.1371/journal.pone.0281801] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
A rapidly aging population means many people have multiple health issues leading to an increased risk of acute medical emergencies. The objective of this study was to evaluate how essential experiential learning is in developing dental graduates' ability to manage medically compromised patients. Three hundred and twenty-seven students and graduates were invited to participate in an online survey to rate their confidence in managing medically compromised patients and acute medical emergencies using a 5-point Likert scale. Competence of knowledge was evaluated using 30 multiple choice questions (MCQs) across six domains. The respondents were also asked whether a theory-only training adequately prepared them to manage medically compromised patients, or whether it must be supplemented with clinical training. Two-hundred and sixty-four responses were collected from 75 undergraduates (UG), 96 junior dental officers (JDO) and 93 senior dental officers (SDO). The UG reported that they infrequently managed medically compromised patients, whereas both the JDO and SDO reported having frequent encounters with these patients. The mean confidence scale in the management of medically compromised patients were 2.62, 3.50 and 3.69 (out of 5), respectively. In contrast, their confidence scale in the management of acute medical emergencies was 2.05, 2.33 and 2.50 (out of 5), respectively. The MCQ scores were 25.51, 26.44 and 26.86 out of 30, respectively. The outcomes of the JDO and SDO were significantly better than the UG (t-tests, p<0.05). All three groups responded that a theory-only training in dental school did not adequately prepare them to manage medically compromised patients. Both the JDO and SDO felt that their clinical work experience better prepared them to manage these patients. Experiential learning from "real-life" clinical experience is an essential component in developing graduates' confidence and competence in the management of medically compromised patients. A dental curriculum with theory-only training in this aspect is inadequate.
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Yang F, Zheng C, Zhu T, Zhang D. Assessment of life support skills of resident dentists using OSCE: cross-sectional survey. BMC MEDICAL EDUCATION 2022; 22:710. [PMID: 36207714 PMCID: PMC9541086 DOI: 10.1186/s12909-022-03775-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The aim of this cross-sectional survey was to apply the Objective Structured Clinical Examination (OSCE) to evaluate the cardiopulmonary resuscitation (CPR) and endotracheal intubation skills of resident dentists for stage assessment in standardized training. METHODS A total of 146 third-year resident dentists were recruited and randomly assigned to perform either CPR or endotracheal intubation. Their performance was scored by experienced anesthesiologists with standardized scoring criteria. Participants were also asked to rated their self-assessed competence, willingness, and perceptions on training status using Likert-type scales in a questionnaire. Student's ttest was applied to compare scores for CPR and endotracheal intubation performed by resident dentists with different characteristics. The results of the questionnaires were analyzed and visualized by the R package 'Likert'. Significance was set at the P < 0.05 level. RESULTS The mean OSCE score for endotracheal intubation (59.1 ± 12.5) was lower than that of CPR (72.4 ± 8.8). Participants with Master's degrees scored higher than those with Bachelor's degrees and Doctor of Philosophy (PhD) degrees in the assessment of CPR and endotracheal intubation. Low scores of self-assessed competence and willingness were observed, especially for endotracheal intubation. Resident dentists showed poor satisfaction on training volume and frequency of CPR and endotracheal intubation. CONCLUSION Resident dentists showed poor performance on CPR and endotracheal intubation assessed by the OSCE. Relatively low self-assessed competence and willingness were reported in endotracheal intubation. The medical emergency curriculum for resident dentists should be more consistent and standardized to help resident dentists enhance the proficiency of life support skills.
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Affiliation(s)
- Fan Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Chen Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Tianer Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
| | - Denghui Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006 China
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15
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Knowledge, Attitude and Practice of Dental Interns and Postgraduates towards Managing Medical Emergencies in Dental Chair. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2022. [DOI: 10.52547/jrdms.7.4.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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16
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Abdulrahman BI, Alasmari KM, Alratiq MN, Alherab FA, Alfantoukh MA, Alherab AA. Are dental professionals ready to deal with medical emergencies in their clinical office? A survey of university hospitals. J Med Life 2022; 15:979-986. [PMID: 36188656 PMCID: PMC9514817 DOI: 10.25122/jml-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/28/2022] [Indexed: 11/21/2022] Open
Abstract
This research aimed to assess the availability and need of dental emergency kits in Saudi Arabia university hospitals. A cross-sectional study was conducted among 267 dentists, including undergraduate, dental interns, general dentists, and specialists in 6 university hospitals (private and government colleges). In addition, a closed-ended questionnaire was distributed through emails using the online platform. The data revealed that 49.4% of dentists faced medical emergencies. Out of them, 72.7% said that emergency kits were available in their clinics. Sugar sources and oxygen were most commonly available. On the other hand, 37.8% of dentists handled emergencies independently, 34.5% considered themselves competent with cardiopulmonary resuscitation (CPR), and 28.8% were confident of using emergency (ER) drugs. The most common medical emergencies were vasovagal syncope and hypoglycemia. The emergency kit in dental clinics is relatively available, and the incidence of medical emergencies is relatively minor. However, the competence and confidence of the dentists in tackling an emergency is low, including handling of emergency (ER), knowledge of CPR, and its performance. Therefore, CPR courses should be improved and promoted more widely for this purpose.
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Affiliation(s)
- Baraa Issam Abdulrahman
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia,Corresponding Author: Baraa Issam Abdulrahman, Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia. E-mail:
| | - Khaled Mohammed Alasmari
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Majed Nasser Alratiq
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Fahad Adel Alherab
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | - Abdullah Adel Alherab
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
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Braimah R, Ali-Alsuliman D, Taiwo A, Alyami B, Ibikunle A, Alwalah A, Almunajjim H, Alalharith A. Medical emergencies during exodontia in a referral dental center in Saudi Arabia: A cross-sectional study. SCIENTIFIC DENTAL JOURNAL 2022. [DOI: 10.4103/sdj.sdj_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Jaber L, Al-Qarni F, Alsaati M, Al-Nefaiee M, Shetty AC, Shaban S, Zarka R, Aljundi A, Jaber B. Perspectives of Dental Practitioners Regarding Their Readiness for Medical Emergencies: A Study in Saudi Arabia. Open Dent J 2021. [DOI: 10.2174/1874210602115010728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Training dental practitioners on emergency preparedness and response is essential for the successful management of medical emergencies.
Objectives:
To assess the perceptions of dental practitioners in Saudi Arabia about their readiness to manage medical emergencies in the dental practices.
Methods:
This cross-sectional survey was conducted among dental practitioners working in 52 dental centers in Saudi Arabia. Questionnaires mainly gathered data on the measures taken by dental practitioners to prevent medical emergencies, BLS certification, availability of essential drugs and equipment, and perceptions of dental practitioners regarding the adequacy of their training for medical emergencies.
Results:
Of the total 270 participants, the majority reported that they take medical history (94%), perform visual inspection (90%), consult with patients’ physician when needed (89%), and modify treatment plan as necessary (94%). However, only 19% of them routinely take baseline vital signs for their patients and 52.6% have valid BLS certification. Only 29.6% and 16.3% of dental practitioners have reported that they have all essential drugs and equipment, respectively.
Conclusion:
The preventive measures for medical emergency appears to be deficient because most dental practitioners are not routinely taking baseline vital signs for their patients. This important issue is combined with shortage of BLS certification among dental practitioners and inadequate availability of all medical emergency drugs and equipment in dental practices.
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Abed H, Obaid M, Al-Johani K. The association between medical diseases and orofacial abscess: A retrospective, hospital-based study. Saudi Dent J 2021; 33:731-737. [PMID: 34803327 PMCID: PMC8589582 DOI: 10.1016/j.sdentj.2020.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/24/2020] [Accepted: 03/30/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aimed to identify the most commonly reported medical diseases among dental patients and to assess its association with the development of the orofacial abscess. METHODS The medical records (n = 3164) of dental patients who visited the dental hospital at Umm-Al-Qura University (Makkah, Saudi Arabia) were reviewed. Demographic characteristics of eligible patients were collected. Medical diseases were collected as reported by the patients in the medical records. The International Classification of Diseases (ICD-10) was used to classify the reported medical diseases. Simple descriptive statistics were used to define the characteristics of the study variables through a form of counts and percentages. Multivariable logistic regression analysis was carried out to find out the significant predictors of orofacial abscess. RESULTS Upon reviewing 3164 medical records, almost half of the patients had medical diseases (n = 1543, 49%). The mean age of the cohort was 30.3 (SD = 16.43). Diabetes mellitus (n = 316, 20%) and hypertension (n = 210, 14%) were the most common reported medical diseases. Male patients reported having more medical diseases compared to the female. Hypertension was found to be significantly high among female patients (X 2 = 3.167, P-value < 0.001). Multivariable logistic regression analysis indicated that the female gender is significantly associated with the development of orofacial abscess after adjustment for age and vascular risk factors (i.e., hypertension) (B = 1.26, S.E. = 0.57, OR = 3.54, 95%CI = 1.13 to 11.40, P-value = 0.028). CONCLUSION Dentists should be aware that diabetes mellitus and hypertension are prevalent among patients visiting dental services. The female gender has a higher association of developing orofacial abscess than male. Within the limitation of this study in a single study center with few patients having orofacial abscess, this study found no association between medical diseases and the development of orofacial abscess.
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Affiliation(s)
- Hassan Abed
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Sedation and Special Care Dentistry, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Majed Obaid
- Department of Community Medicine and Medical Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Division of Health and Social Care, School of Population Health and Environmental Science, King’s College London, London, United Kingdom
| | - Khalid Al-Johani
- Department of Oral Diagnostic Science, Faculty of Dentistry, King Abdul-Aziz University, Jeddah, Saudi Arabia
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Hutse I, Coppens M, Herbelet S, Seyssens L, Marks L. Syncope in Dental Practices: A Systematic Review on Aetiology and Management. J Evid Based Dent Pract 2021; 21:101581. [PMID: 34479666 DOI: 10.1016/j.jebdp.2021.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/01/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This systematic review aimed to give an overview of the current evidence surrounding the aetiology and management in terms of treatment and prevention of syncope in dental practices. Alongside the occurrence, the practitioner's competence, and the association between syncope and local anaesthetics were discussed. METHODS An electronic search in EMBASE, Web of Science, PubMed, Cochrane databases and a hand search were performed by 2 independent reviewers to identify studies up to November 2019. Eligibility criteria were applied and relevant data was extracted. Inclusion criteria covered all types of dental treatment under local anaesthesia or conscious sedation performed by a wide range of oral health care workers in their practices. Risk of bias of the included studies was assessed using the methodological tools recommend by Zeng et al.1 No restrictions were made to exclude papers from qualitive analysis based on risk of bias assessment. RESULTS The search yielded a total of 18 studies for qualitative analysis. With the exception of one prospective cohort study, all articles were considered having a high risk of bias. Meta-analysis showed that dentists encountered on average 1.2 cases of syncope per year. The male gender (RR = 2.69 [1.03, 7.02]), dental fear (RR = 3.55 [2.22, 5.70]), refusal of local anaesthesia in non-acute situations (OR = 12.9) and the use of premedication (RR = 4.70, [1.30, 16.90]) increased the risk for syncope. Treatment and prevention were underreported as both were solely discussed in one study. The supine recovery position with raised legs and oxygen administration (15l/min) was presented as an effective treatment. The Medical Risk-Related History (MRRH) system was proposed as prevention protocol, yet this protocol was ineffective in reducing incidence rates (p = 0.27). The majority of dentists (79.2%) were able to diagnose syncope, yet most (86%) lacked the skills for appropriate treatment. Only 57,6% of dental practices were equipped with an oxygen cylinder. CONCLUSIONS Syncope is the most common emergency in dental practices. Nonetheless, the vast majority of dentists do not seem competent nor prepared to manage this emergency. Psychogenic factors seem to play an important role in provoking syncope. Placing the patient in a supine reclined position with raised legs in combination with the administration of oxygen seems effective for regaining consciousness. Although valuable in many aspects, risk assessment by medical history taking is not proven to result in fewer episodes. The strength of these conclusions is low based on GRADE guidelines.2.
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Affiliation(s)
- Irene Hutse
- Department of Oral Health Sciences, Special Needs in Dentistry, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Marc Coppens
- Department of Basic and Applied Medical Sciences, Anaesthesiology and Peri-operative Medicine, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Sandrine Herbelet
- Department of Basic and Applied Medical Sciences, Anaesthesiology and Peri-operative Medicine, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Lorenz Seyssens
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Luc Marks
- Department of Oral Health Sciences, Special Needs in Dentistry, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium; Center for Dentistry and Oral hygiene, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, Netherlands.
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21
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Mohideen K, Thayumanavan B, Krithika C, Nazia R, Murali B, Pravda C, Arshadha M. The Knowledge and Awareness of Medical Emergencies and Management among Dental Students. J Pharm Bioallied Sci 2021; 13:S741-S747. [PMID: 34447193 PMCID: PMC8375915 DOI: 10.4103/jpbs.jpbs_559_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/30/2020] [Accepted: 11/18/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Every dentist should anticipate being confronted with a medical emergency (ME), and one should always be ready to treat the most catastrophic ones. Aim: This study aimed to assess the knowledge of dental clinical students of Tamil Nadu in the ME understanding and management to create awareness toward patient care. Methodology: A total of 768 dental students, including final-year students and residents from different colleges, took part in the questionnaire-based cross-sectional study. The selection of study participants was by the convenience sampling method. The questionnaire contained thirty closed multiple-choice questions to assess their knowledge of MEs. Microsoft Office Excel software was used for compiling the answers. The descriptive analysis of the data is exhibited in graphs. Results: The majority of participants were mindful of the vital signs; only 55% of the participants know the importance of checking their respiration rate. The knowledge of identifying MEs such as anaphylaxis was 91%, and only 27%–37% of the respondents knew to identify angina, transient ischemia, and lidocaine toxicity. Approximately 15%–40% of the respondents only knew the management of angina, cardiac arrest, hyperventilation, respiratory obstruction, and seizure. Only 10% agreed that the best office emergency kit should be prepared by themselves. Roughly 78% of the respondents were conscious of the patient's referral whenever necessary and aware of state dental acts. Conclusion: This study reflects a significant need for training in executing ME among dental students who are to transmute into future dental professionals.
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Affiliation(s)
- Khadijah Mohideen
- Department of Oral Pathology and Microbiology, Sathyabama Institute of Science and Technology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Balakrishnan Thayumanavan
- Department of Oral Pathology and Microbiology, Sathyabama Institute of Science and Technology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - C Krithika
- Department of Oral Medicine and Radiology, Dr. M.G.R. Educational and Research Institute, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Balasubramaniam Murali
- Department of Oral Pathology and Microbiology, Sathyabama Institute of Science and Technology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - C Pravda
- Department of Oral Medicine and Radiology, Sathyabama Institute of Science and Technology, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
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Facco E, Bacci C, Zanette G. Hypnosis as sole anesthesia for oral surgery: The egg of Columbus. J Am Dent Assoc 2021; 152:756-762. [PMID: 34332655 DOI: 10.1016/j.adaj.2021.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OVERVIEW Hypnosis, despite its effectiveness, has been neglected. The aim of this study is to show the effectiveness and manageability of hypnosis as a stand-alone technique in dentistry. CASE DESCRIPTION Three patients underwent 6 oral surgery procedures (surgical third-molar removal, implant surgery, maxillary bone augmentation, and mucogingival surgery) with hypnosis as the only anesthetic. Two of the 3 patients had difficulties: 1 was sensitive to multiple chemicals, had Addison disease, and had previously experienced anaphylactic reactions to local anesthetics; the other was allergic to lidocaine and had undergone a paradoxical reaction to pharmacologic sedation in the past. All 3 patients had 2 preoperative sessions each to assess their perioperative risk, level of anxiety, hypnotic susceptibility, and capacity to develop full hypnotic analgesia. On a surgery day, hypnosis was induced and hypnotic analgesia was obtained according to a standard protocol, a procedure taking no more than 9 minutes in each case. Each surgical procedure was then completed successfully with the patient in a painless condition of full relaxation and sense of well-being, with stable cardiovascular parameters. None of the patients required postoperative analgesics, which were prescribed for use as needed. CONCLUSIONS AND PRACTICAL IMPLICATIONS Hypnosis is a valuable tool in dentistry, enabling the safe and rapid relief of anxiety and phobia and raising patient pain thresholds to the level of surgical analgesia. Unlike drugs and equipment, it is always readily available, cost-free, and has no adverse effects when administered by competent professionals. Hypnosis can be used for sedation in most patients and as a stand-alone technique in those with appropriate hypnotic susceptibility, improving the well-being and safety of patients.
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Manton JW, Kennedy KS, Lipps JA, Pfeil SA, Cornelius BW. Medical Emergency Management in the Dental Office (MEMDO): A Pilot Study Assessing a Simulation-Based Training Curriculum for Dentists. Anesth Prog 2021; 68:76-84. [PMID: 34185862 PMCID: PMC8258755 DOI: 10.2344/anpr-67-04-04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/20/2020] [Indexed: 11/11/2022] Open
Abstract
In the event of a medical emergency in the dental office, the dentist must be able to identify a patient in distress, assess the situation, and institute proper management. This study assessed the impact of a simulation-based medical emergency preparedness curriculum on a resident's ability to manage medical emergencies. This interventional and pre-post educational pilot study included 8 participants who completed a standard curriculum and 8 who completed a modified curriculum (N = 16). The intervention consisted of a comprehensive medical emergency preparedness curriculum that replaced lecture sessions in a standard curriculum. Participants completed performance assessments using scenario-based objective structured clinical examinations (OSCEs) that were recorded and evaluated by calibrated faculty reviewers using a customized scoring grid. The intervention group performed significantly better than the control group on their summative OSCEs, averaging 90.9 versus 61.2 points out of 128 (p = .0009). All participants from the intervention group passed their summative OSCE with scores >60%, while none from the control group received passing scores. Completion of a simulation-based medical emergency preparedness curriculum significantly improved resident performance during simulated medical emergencies.
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Affiliation(s)
- Jesse W Manton
- The Ohio State University, College of Dentistry, Division of Oral and Maxillofacial Surgery and Dental Anesthesiology
- The Ohio State University, College of Medicine, Department of Anesthesiology
| | - Kelly S Kennedy
- The Ohio State University, College of Dentistry, Division of Oral and Maxillofacial Surgery and Dental Anesthesiology
| | - Jonathan A Lipps
- The Ohio State University, College of Medicine, Department of Anesthesiology
| | - Sheryl A Pfeil
- The Ohio State University, College of Medicine, Medical Director-Clinical Skills Education and Assessment Center
- The Ohio State University, College of Medicine, Department of Internal Medicine Division of Gastroenterology, Hepatology and Nutrition, Columbus, Ohio
| | - Bryant W Cornelius
- The Ohio State University, College of Dentistry, Division of Oral and Maxillofacial Surgery and Dental Anesthesiology
- The Ohio State University, College of Medicine, Department of Anesthesiology
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Solanki C, Geisinger ML, Luepke PG, Al-Bitar K, Palomo L, Lee W, Blanchard S, Shin D, Maupome G, Eckert GJ, John V. Assessing readiness to manage medical emergencies among dental students at four dental schools. J Dent Educ 2021; 85:1462-1470. [PMID: 33997984 DOI: 10.1002/jdd.12640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/09/2021] [Accepted: 04/03/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Dentists treat a wide range of patients, including patients with compromised health conditions. While rendering treatment, various medical emergencies can and do occur. To help increase the knowledge required to manage such emergencies, dental students must be trained while in dental school. This study aims to assess the level of medical emergency preparedness and knowledge among dental students at four dental schools. MATERIAL AND METHODS The participating dental schools were IUSD, Case Western Reserve University School of Dentistry, Marquette University School of Dentistry, and the University of Alabama School of Dentistry. Groups were designed to include 20 dental students from Years 1 to 4. Students were asked to fill out a survey and were then tested on 10 clinical medical emergency scenarios. RESULTS A total of 331 dental students participated in the study. The scores based on 10 case scenarios presented with a range of 4.35-8.02. There was no statistically significant difference in the level of preparedness when dental schools were compared. However, Year 1 and Year 2 dental students had significantly lower total scores than those of Years 3 and 4. The students in Years 1 and 2 demonstrated less confidence in their current knowledge to manage medical emergencies. Satisfaction with the training received ranged from 38% to 84%. CONCLUSION The results from this study indicate that students' preparedness to manage medical emergencies at these four dental schools is statistically similar. Additional yearly training could enhance students' preparedness in the management of medical emergencies in the dental setting.
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Affiliation(s)
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Paul G Luepke
- Department of Periodontology, College of Dentistry, UTHSC, Memphis, Tennessee, USA
| | | | - Leena Palomo
- Department of Periodontology, Case Western School of Dental Medicine, Cleveland, Ohio, USA
| | - Wangsoo Lee
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Steven Blanchard
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Daniel Shin
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Gerardo Maupome
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - George J Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vanchit John
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Hashim R, Mathew LS, Rustom S, Amer F, Odeh R. Emergency medical care in dentistry: A cross sectional analysis of competencies for undergraduate students. Int J Crit Illn Inj Sci 2021; 11:33-38. [PMID: 34159135 PMCID: PMC8183368 DOI: 10.4103/ijciis.ijciis_107_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 01/28/2020] [Accepted: 02/13/2020] [Indexed: 11/05/2022] Open
Abstract
Background: The possibility of a medical crisis, albeit a relatively uncommon occurrence in a dental practice, is often overlooked and it is imperative that dental practitioners equip themselves with the knowledge and skills essential to manage potentially life-threatening situations. The aim of this study was to evaluate the knowledge and competency levels of dental undergraduate students training across universities in the UAE in basic life support (BLS) and medical emergencies in a dental setting. Methods: A cross-sectional survey-based study was conducted and 411 students undergoing clinical training (4th and 5th year of dental school) voluntarily participated in this study. The questionnaire comprised questions related to commonly occurring medical emergencies that they may have encountered in a dental setting. Data collected were then tabulated and subjected to descriptive statistical analysis. Results: More than half of the respondents (55.2%) reported that they had lower confidence in handling medical emergencies, with 54.7% claiming that they had not received training on the subject during their undergraduate course. Majority of the respondents (216) reported that they would only choose to record vital signs if the medical history of the patient was indicative of an underlying condition. Discussion: Findings from the present study strongly mandate the inclusion of training for BLS and medical emergencies in the existing dental curriculum to equip graduate dental practitioners to handle a medical crisis in their dental practice.
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Affiliation(s)
- Raghad Hashim
- Department of Growth and Development, College of Dentistry, Ajman University, Ajman, UAE
| | - Lity Susan Mathew
- Department of Growth and Development, College of Dentistry, Ajman University, Ajman, UAE
| | - Suhad Rustom
- Department of Growth and Development, College of Dentistry, Ajman University, Ajman, UAE
| | - Fatima Amer
- Department of Growth and Development, College of Dentistry, Ajman University, Ajman, UAE
| | - Ruba Odeh
- Department of Growth and Development, College of Dentistry, Ajman University, Ajman, UAE
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Sorenson AD, Marusko RM, Kennedy KS. Medical emergencies in the dental school setting. J Dent Educ 2021; 85:1223-1227. [PMID: 33754336 DOI: 10.1002/jdd.12590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 11/06/2022]
Abstract
PURPOSE/OBJECTIVES An aging population with an increasing chronic disease burden may make management of medical emergencies in dental practice more common. Previous research has differed significantly in the reported frequency of medical emergencies in a dental setting, often relying on survey-based protocols. This study examines the incidence and type of emergencies encountered in a dental school setting. Additional examination of contributing medical co-morbidities is provided. METHODS A retrospective study was designed to review 121 incident reports at the Ohio State University College of Dentistry (OSU CoD) from July 1, 2013 to January 24, 2019. Sixty-five of the recorded events were classified as medical emergencies and were further analyzed. RESULTS The most common emergency encountered was syncope, followed by cardiac events, seizures, and diabetic complications. Emergencies most commonly occurred in the pre-doctoral general dentistry clinics. Many of the affected patients had no significant medical history. CONCLUSION Identifying emergencies most encountered by dentists is critical for process improvement, awareness, and targeted educational initiatives. This may reduce the frequency of medical emergencies in dental practices and allow for more efficient management should they occur.
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Affiliation(s)
- Adam D Sorenson
- Department of Oral and Maxillofacial Surgery, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Robert M Marusko
- College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Kelly S Kennedy
- Department of Oral and Maxillofacial Surgery, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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Al-Johani K, Jamal BT, Hassan M, Al-Sebaei MO. Knowledge and Attitude of Dental Students Towards Medical Emergencies at King Abdulaziz University, Jeddah, Saudi Arabia. ANNALS OF DENTAL SPECIALTY 2021. [DOI: 10.51847/yrxgh18nn1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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28
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Shete A, Shete M, Kulkarni T, Chinte A, Nerkar A, Kshirsagar K. Assessment of level of knowledge, awareness, and attitude toward “Basic Life Support” and “Cardiopulmonary Resuscitation” among dental students, interns, and dental practitioners. INDIAN JOURNAL OF DENTAL SCIENCES 2021. [DOI: 10.4103/ijds.ijds_192_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jevon P. Medical emergencies in the dental practice poster: revised and updated. BDJ TEAM 2020. [PMCID: PMC7677740 DOI: 10.1038/s41407-020-0474-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kim SY, Shin D, Kim HJ, Karm MH. Changes of knowledge and practical skills before and after retraining for basic life support: Focused on students of Dental School. Int J Med Sci 2020; 17:3082-3090. [PMID: 33173429 PMCID: PMC7646099 DOI: 10.7150/ijms.47343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/07/2020] [Indexed: 11/06/2022] Open
Abstract
Background: Considering the increasing possibility of emergency situations in dental clinics over time, we conducted this study to evaluate the changes in the knowledge and practical skills of students of dental school before and after retraining for 2 years after the initial education on basic life support (BLS) of the American Heart Association (AHA). Methods: All third-year students of dental school who had received the same education on BLS provider training of the AHA 2 years earlier were included in this study. Among them, 98 students were asked to answer a questionnaire about BLS knowledge and conduct a practical skills assessment of high-quality cardiopulmonary resuscitation using Little Anne QCPR before and after retraining. Results: After retraining, the level of BLS knowledge increased in all 7 categories, and BLS performance increased in all 19 subcategories. Comparison of the QCPR numerical data items before and after retraining showed that all items after retraining met the criteria recommended by the AHA. Conclusion: Students of dental school had low levels of knowledge and practical skills of BLS before retraining after 2 years from the initial education and had high levels after retraining. Therefore, BLS training must be updated periodically, and more effective education methods are required to maintain BLS knowledge and practical skills.
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Affiliation(s)
- Seo-Yoon Kim
- Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Dongmin Shin
- Department of Emergency Medical Service, Korea National University of Transportation, Chungcheongbuk-do, Republic of Korea
| | - Hyun Jeong Kim
- Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Myong-Hwan Karm
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Republic of Korea
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Abstract
Medical emergencies can occur in the dental practice. The posters 'Medical Emergencies in the Dental Practice' and 'Emergency Drugs in the Dental Practice' have been designed to help dental care professionals to respond effectively and safely to a medical emergency. They have been updated and completely revised in line with current national guidelines and recommendations. The 'Medical Emergencies in the Dental Practice' poster is available as an insert in this issue of the British Dental Journal. Both posters are available to download from https://www.bda.org/advice/Pages/Patient-care.aspx .
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Affiliation(s)
- Phil Jevon
- Academy Tutor, Walsall Teaching Academy, Manor Hospital, Walsall, UK.
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Gaiser M, Kirsch J, Mutzbauer TS. Using Nonexpert Online Reports to Enhance Expert Knowledge About Causes of Death in Dental Offices Reported in Scientific Publications: Qualitative and Quantitative Content Analysis and Search Engine Analysis. J Med Internet Res 2020; 22:e15304. [PMID: 32038029 PMCID: PMC7195661 DOI: 10.2196/15304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/29/2019] [Accepted: 02/03/2020] [Indexed: 11/29/2022] Open
Abstract
Background Fatalities rarely occur in dental offices. Implications for clinicians may be deduced from scientific publications and internet reports about deaths in dental offices. Objective Data involving deaths in dental facilities were analyzed using Google as well as the PubMed database. By comparing both sources, we examined how internet data may enhance knowledge about deaths in dental offices obtained from scientific medical publications, which causes of death are published online, and how associated life-threatening emergencies may be prevented. Methods To retrieve relevant information, we searched Google for country-specific incidents of death in dental practices using the following keywords: “death at the dentist,” “death in dental practice,” and “dying at the dentist.” For PubMed searches, the following keywords were used: “dentistry and mortality,” “death and dental treatment,” “dentistry and fatal outcome,” and “death and dentistry.” Deaths associated with dental treatment in a dental facility, attributable causes of death, and documented ages of the deceased were included in our analysis. Deaths occurring in maxillofacial surgery or pre-existing diseases involved in the death (eg, cancer and abscesses) were excluded. A total of 128 cases from online publications and 71 cases from PubMed publications that met the inclusion criteria were analyzed using chi-square statistics after exclusion of duplicates. Results The comparison between the fatalities from internet (n=117) and PubMed (n=71) publications revealed that more casualties affecting minors appeared online than in PubMed literature (online 68/117, 58.1%; PubMed 20/71, 28%; P<.001). In PubMed articles, 10 fatalities in patients older than 70 years of age were described, while online sources published 5 fatalities (P=.02). Most deaths, both from internet publications and PubMed literature, could be assigned to the category anesthesia, medication, or sedation (online 80/117, 68.4%; PubMed 25/71, 35%; P<.001). Deaths assigned to the categories infection and cardiovascular system appeared more often in the PubMed literature (infection: online 10/117, 8.5%; PubMed 15/71, 21%; P=.01; cardiovascular system: online 5/117, 4.3%; PubMed 15/71, 21%; P<.001). Furthermore, sedative drugs were involved in a larger proportion of fatal incidents listed online compared to in PubMed (online 41/117, 35.0%; PubMed: 14/71, 20%, P=.03). In the United States, more deaths occurred under sedation (44/96, 46%) compared to those in the other countries (Germany and Austria 1/17, 6%, P=.002; United Kingdom 1/14, 7%, P=.006). Conclusions Online and PubMed databases may increase awareness of life-threatening risks for patients during dental treatment. Negative aspects of anesthesia and sedation, as well as the number of deaths of young patients, were underestimated when reviewing PubMed literature only. Medical history of patients, medication dosages, and vital function monitoring are significant issues for practitioners. A high-impact finding from online reports was the underestimation of risks when performing sedation and even general anesthesia. Detailed knowledge of the definition and understanding of deep sedation and general anesthesia by dentists is of major concern. By avoiding potentially hazardous procedures, such as sedation-aided treatments performed solely by dentists, the risk of treatment-induced life-threatening emergencies may be reduced.
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Affiliation(s)
- Meike Gaiser
- Institute for Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany
| | - Joachim Kirsch
- Institute for Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany
| | - Till Sebastian Mutzbauer
- Institute for Anatomy and Cell Biology, University of Heidelberg, Heidelberg, Germany.,Maxillofacial Surgery and Dental Anesthesiology, Mutzbauer & Partner, Zürich, Switzerland
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Irfan B, Zahid I, Khan MS, Khan OAA, Zaidi S, Awan S, Bilal S, Irfan O. Current state of knowledge of basic life support in health professionals of the largest city in Pakistan: a cross-sectional study. BMC Health Serv Res 2019; 19:865. [PMID: 31752855 PMCID: PMC6868838 DOI: 10.1186/s12913-019-4676-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/24/2019] [Indexed: 11/24/2022] Open
Abstract
Background Basic Life Support (BLS) is the recognition of sudden cardiac arrest and activation of the emergency response system, followed by resuscitation, and rapid defibrillation. According to WHO, Pakistan has one of the highest mortality rates from accidental deaths therefore assessment and comparison of BLS knowledge in health professionals is crucial. We thereby aim to assess and compare the knowledge of BLS in doctors, dentists and nurses. Methods A multi-centric cross-sectional survey was conducted in Karachi at different institutions belonging to the private as well as government sector from January to March 2018. We used a structured questionnaire which was adapted from pretested questionnaires that have been used previously in similar studies. Descriptive statistics were analyzed using SPSS v22.0, where adequate knowledge was taken as a score of at least 50%. P < 0.05 was considered as significant. Logistic regression was used to identify the factors affecting the knowledge regarding BLS in health care professionals. Results The responders consisted of 140 doctors, nurses and dentists each. Only one individual (dentist) received a full score of 100%. In total, 58.3% of the population had inadequate knowledge. Average scores of doctors, dentists and nurses were 53.5, 43.3 and 38.4% respectively. Doctors, participants with prior training in BLS and those with 6 to 10 years after graduation were found to be a significant predictor of adequate knowledge, on multivariate analysis. Conclusion Even though knowledge of BLS in doctors is better than that of dentists and nurses, overall knowledge of health care professionals is extremely poor. Present study highlights the need for a structured training of BLS for health care workers.
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Affiliation(s)
- Babar Irfan
- Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Ibrahim Zahid
- Dow University of Health Sciences, Karachi, Pakistan.
| | | | | | - Shayan Zaidi
- Jinnah Sindh Medical University, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sobia Bilal
- Faculty School of Dentistry, Lead IMU-Quit Smoking Service, International Medical University, Kuala Lumpur, Malaysia
| | - Omar Irfan
- Peter Gilgan Center of Research and Learning, Hospital for Sick Children, Toronto, Canada
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Vaughan M, Mahoney G, Sholapurkar A, Ray RA. Patients' views on dentists' ability to manage medical crises - results of focus group research. Aust Dent J 2019; 64:338-345. [PMID: 31483862 DOI: 10.1111/adj.12717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Australia faces an ageing population which is more medically complicated than in years past, and it is important that we meet public expectations of management of medical emergencies in the dental clinic. No research before has examined in depth the public perception of dentists' medical emergency management. AIM To qualitatively assess the publics' perception of medical emergencies in dentistry and their expectations of medical emergency management by dentists. METHODS Twelve members of the public associated with a university clinic participated in two focus groups of six persons, where semi-structured discussions were carried out, audio recorded and transcribed, and subsequently underwent comprehensive thematic analysis. RESULTS Key findings included a high expectation of dentists' general medical knowledge, as well as potential concern regarding a lack of routine medical assessment prior to undertaking dental treatment. CONCLUSIONS Participants expected dentists to be highly proficient at managing medical crises and support the concept of medical emergency management certification for dentists.
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Affiliation(s)
- Matthew Vaughan
- Faculty of Dentistry, College of Medicine and Dentistry, James Cook University, 12-88 McGregor Road, Smithfield, Queensland, 4878, Australia
| | - Greg Mahoney
- Private Practice, Manly, Brisbane, 188 Stratton Terrace, Manly, Queensland, 4179, Australia
| | - Amar Sholapurkar
- Faculty of Dentistry, College of Medicine and Dentistry, James Cook University, 12-88 McGregor Road, Smithfield, Queensland, 4878, Australia
| | - Robin A Ray
- Research Education, College of Medicine and Dentistry, James Cook University, Building 39.213 Medical 1, 1 James Cook Dr, Douglas, Queensland, 4814, Australia
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Minoli M, Zechini G, Capparé P, Landoni G. Dental deaths in Italy as reported by online press articles. Oral Dis 2019; 26:858-864. [PMID: 31310434 DOI: 10.1111/odi.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/02/2019] [Accepted: 07/02/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Mortality on the dental chair is a rare and underreported event. This study aimed to identify all deaths that occurred during dental procedures in Italy. METHODS We searched PubMed/Medline, Scopus, and Internet archives looking for patients who died before, during, or after a dental procedure in Italy from 1990 to 2019. RESULTS All the 36 identified fatal events were reported by national or regional newspapers, and none was reported by scientific databases. Interestingly, no cases regarding patients ≤16 years old were found and there was no variation in the number of reported deaths over the years. Most of the cases (n = 29) occurred in out-of-hospital private dental offices. Tooth extraction represented the most frequent culprit operation (39%), while myocardial infarction (28%) was the leading cause of death, followed by cardiac arrest (25%), allergies (11%), and infections (8%). In four cases, death was preprocedural, in 10 intraprocedural and in 21 postprocedural. In 17 cases, a temporal association between injection of anesthesia/sedation and death was observed. CONCLUSION This is the first report on Italian dental procedure-related deaths. Most of these deaths were only temporally associated with a dental procedure and could not to be attributed to malpractice.
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Affiliation(s)
- Margherita Minoli
- Dental School, Vita-Salute San Raffaele University of Milan, Milano, Italy
| | - Giacomo Zechini
- Dental School, Vita-Salute San Raffaele University of Milan, Milano, Italy
| | - Paolo Capparé
- Dental School, Vita-Salute San Raffaele University of Milan, Milano, Italy.,Vita-Salute San Raffaele University of Milan, Milan, Italy
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University of Milan, Milan, Italy
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Smereka J, Aluchna M, Aluchna A, Puchalski M, Wroblewski P, Checinski I, Leskiewicz M, Szarpak L. Medical emergencies in dental hygienists' practice. Medicine (Baltimore) 2019; 98:e16613. [PMID: 31348310 PMCID: PMC6709043 DOI: 10.1097/md.0000000000016613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Dental hygienists in Poland work in various settings, including public health care institutions, private dental practices, dental clinics, kindergartens, and schools. They can often face medical emergencies, whose rate is increasing owing to comorbidities and aging of dental patients' populations. The aim of the study was to assess the prevalence of medical emergencies in dental hygienists' practice in Poland and the hygienists' preparedness and attitudes toward emergencies.A 10-question authors' own questionnaire was filled in by 613 dental hygienist. It referred to their cardiopulmonary resuscitation training, availability of emergency medical equipment in the workplace, the prevalence of medical emergencies including the need for an emergency medical service (EMS) call, and the management of cardiac arrest.Overall, 613 dental hygienists working in Poland participated in the study; 38.99% had taken part in basic life support (BLS) training within the previous 12 months and 35.89% within 2 to 5 years; 15.17% had experienced at least 1 emergency situation requiring an EMS call within the previous 12 months. Vasovagal syncope was the most common medical emergency (15.97%), followed by moderate anaphylactic reaction (13.87%), seizures (8.81%), hyperventilation crisis (7.50%), and hypoglycemia (7.34%).The most common medical emergency in dental hygienists' practice in Poland is syncope followed by mild anaphylactic reaction. Most of the dental hygienist had participated in a BLS course within the previous 5 years; however, 20% of them have never participated since graduation. Dental hygienists should participate in BLS courses every 2 years to keep the cardiopulmonary resuscitation skills and stay up-to-date with current guidelines. An important part of the study participants declare the lack of availability in their workplaces of life-saving equipment, including self-expanding bag resuscitator, oropharyngeal, and supraglottic airway device and oxygen source. Medical emergency equipment as recommended in the international guidelines should be available in every practice.
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Affiliation(s)
- Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Marcin Aluchna
- Department of Conservative Dentistry, Medical University of Warsaw
| | | | - Marcin Puchalski
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Pawel Wroblewski
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Igor Checinski
- Department of Emergency Medical Service, Wroclaw Medical University
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McKenzie CT, Tilashalski K, Abou-Arraj R, Peterson DT, White ML. Students' Evaluations of Simulations in Dentistry: A Multiple Cohort Study at a U.S. Dental School. J Dent Educ 2019; 83:1142-1150. [PMID: 31235505 DOI: 10.21815/jde.019.121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 04/18/2019] [Indexed: 12/21/2022]
Abstract
Simulation may help translate didactic learning to patient care in areas such as communication skills and medical emergency management. The aims of this study were to investigate how multiple cohorts of dental students evaluated simulations utilizing standardized patients and manikins and to explore evaluations of a simulation that combined social determinants of health with oral health education. All approximately 600 second- and fourth-year dental students at one U.S. dental school participated in simulation activities for five years (2014-18). The activities involved clinical communication skills with an urgent care patient, medical emergency management, and communication skills with a parent with low income. After the simulations, students were invited to complete an evaluation of the experience. Questionnaire items addressed perceived applicability to patient care, value of the experience, and fulfillment of objectives; and open-ended questions asked for comments specific to the parent with low income simulation. A total of 497 responses from D2 and D4 students were collected over the five-year period, as well as from all 12 periodontics residents in 2017, for an overall 91.7% response rate. The vast majority (>90.6%) positively evaluated all items for each simulation. The positive ratings ranged from a mean of 99.3% for the urgent care simulation to 93.8% for the parent with low income simulation. Positive student comments often related to learning from/with others and effective practice of teach back and patient education tactics. Students' most frequent suggestions for improvement called for better preparation. In this study, simulations with both standardized patients and manikins led to positive evaluations as well as anticipated improvement of clinical performance. These results suggest that incorporating simulation into an already-crowded curriculum is worth it from the student perspective, especially for reinforcement of clinical skills not easily amenable to classroom instruction.
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Affiliation(s)
- Carly T McKenzie
- Carly T. McKenzie, PhD, is Assistant Professor, Department of Clinical and Community Sciences, Behavioral and Population Sciences Division, School of Dentistry, The University of Alabama at Birmingham; Ken Tilashalski, DMD, is Professor, Department of Restorative Sciences and Associate Dean for Academic Affairs, School of Dentistry, The University of Alabama at Birmingham; Ramzi Abou-Arraj, DDS, MS, is Associate Professor, Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham; Dawn Taylor Peterson, PhD, is Assistant Professor, Department of Medical Education, School of Medicine and Department of Health Services Administration, School of Health Professions, as well as Director of Faculty Development and Training, Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham; and Marjorie Lee White, MD, MA, MPPM, is Professor, Departments of Pediatric Emergency Medicine and Medical Education, School of Medicine and School of Health Professions, Assistant Dean for Clinical Simulation, and Director of Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham.
| | - Ken Tilashalski
- Carly T. McKenzie, PhD, is Assistant Professor, Department of Clinical and Community Sciences, Behavioral and Population Sciences Division, School of Dentistry, The University of Alabama at Birmingham; Ken Tilashalski, DMD, is Professor, Department of Restorative Sciences and Associate Dean for Academic Affairs, School of Dentistry, The University of Alabama at Birmingham; Ramzi Abou-Arraj, DDS, MS, is Associate Professor, Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham; Dawn Taylor Peterson, PhD, is Assistant Professor, Department of Medical Education, School of Medicine and Department of Health Services Administration, School of Health Professions, as well as Director of Faculty Development and Training, Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham; and Marjorie Lee White, MD, MA, MPPM, is Professor, Departments of Pediatric Emergency Medicine and Medical Education, School of Medicine and School of Health Professions, Assistant Dean for Clinical Simulation, and Director of Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham
| | - Ramzi Abou-Arraj
- Carly T. McKenzie, PhD, is Assistant Professor, Department of Clinical and Community Sciences, Behavioral and Population Sciences Division, School of Dentistry, The University of Alabama at Birmingham; Ken Tilashalski, DMD, is Professor, Department of Restorative Sciences and Associate Dean for Academic Affairs, School of Dentistry, The University of Alabama at Birmingham; Ramzi Abou-Arraj, DDS, MS, is Associate Professor, Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham; Dawn Taylor Peterson, PhD, is Assistant Professor, Department of Medical Education, School of Medicine and Department of Health Services Administration, School of Health Professions, as well as Director of Faculty Development and Training, Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham; and Marjorie Lee White, MD, MA, MPPM, is Professor, Departments of Pediatric Emergency Medicine and Medical Education, School of Medicine and School of Health Professions, Assistant Dean for Clinical Simulation, and Director of Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham
| | - Dawn Taylor Peterson
- Carly T. McKenzie, PhD, is Assistant Professor, Department of Clinical and Community Sciences, Behavioral and Population Sciences Division, School of Dentistry, The University of Alabama at Birmingham; Ken Tilashalski, DMD, is Professor, Department of Restorative Sciences and Associate Dean for Academic Affairs, School of Dentistry, The University of Alabama at Birmingham; Ramzi Abou-Arraj, DDS, MS, is Associate Professor, Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham; Dawn Taylor Peterson, PhD, is Assistant Professor, Department of Medical Education, School of Medicine and Department of Health Services Administration, School of Health Professions, as well as Director of Faculty Development and Training, Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham; and Marjorie Lee White, MD, MA, MPPM, is Professor, Departments of Pediatric Emergency Medicine and Medical Education, School of Medicine and School of Health Professions, Assistant Dean for Clinical Simulation, and Director of Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham
| | - Marjorie Lee White
- Carly T. McKenzie, PhD, is Assistant Professor, Department of Clinical and Community Sciences, Behavioral and Population Sciences Division, School of Dentistry, The University of Alabama at Birmingham; Ken Tilashalski, DMD, is Professor, Department of Restorative Sciences and Associate Dean for Academic Affairs, School of Dentistry, The University of Alabama at Birmingham; Ramzi Abou-Arraj, DDS, MS, is Associate Professor, Department of Periodontology, School of Dentistry, The University of Alabama at Birmingham; Dawn Taylor Peterson, PhD, is Assistant Professor, Department of Medical Education, School of Medicine and Department of Health Services Administration, School of Health Professions, as well as Director of Faculty Development and Training, Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham; and Marjorie Lee White, MD, MA, MPPM, is Professor, Departments of Pediatric Emergency Medicine and Medical Education, School of Medicine and School of Health Professions, Assistant Dean for Clinical Simulation, and Director of Office of Interprofessional Simulation for Innovative Clinical Practice, The University of Alabama at Birmingham
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Smereka J, Aluchna M, Aluchna A, Szarpak Ł. Preparedness and attitudes towards medical emergencies in the dental office among Polish dentists. Int Dent J 2019; 69:321-328. [PMID: 30843612 DOI: 10.1111/idj.12473] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Medical emergencies in dental offices are considered a problem in most countries owing to dentists' concerns about emergency preparedness, practical skills, lifesaving equipment and staff availability. The prevalence of medical emergencies in dental offices and dentists' preparedness have been analysed in several countries but have never been studied in Poland. AIM To assess the prevalence of medical emergencies in dental offices in Poland, as well as dentists' preparedness and attitudes towards medical emergencies. METHODS An 18-item questionnaire was completed by 419 dentists. It asked for information on their cardiopulmonary resuscitation training, availability of emergency medical equipment in the dental office, prevalence of medical emergencies and self-assessed competence in various dental office emergencies. Data were analysed using the Statistica 13.3 software package. Variability was measured with standard deviation. Pearson's linear correlation coefficient was used to determine correlation strength. RESULTS The most common medical emergencies in Polish dental offices were vasovagal syncope (46.30% of study participants experienced at least one case in the preceding 12 months), orthostatic hypotension (18.85%), hyperventilation crisis (18.61%), mild allergic reactions (16.23%), hypoglycaemia (15.99%) and seizures (11.81%). The prevalence of medical emergency situations requiring an emergency medical service call or medical assistance within the preceding 12 months was 0 for 80.66% of dentists, one for 12.65%, two for 4.53%, three for 1.20%, four for 0.48%, 5-10 for 0.48% and more than 10 for 0%. As many as 41.29% of the participants did not feel competent in managing sudden cardiac arrest, 74.47% in managing hypertensive crisis, 55.61% in managing asthma, 55.13% in managing anaphylactic shock and 52.99% in managing seizures. CONCLUSION The prevalence of medical emergencies in dental offices in Poland is comparable with that in other countries. A large number of dentists do not feel competent enough to manage medical emergencies. Better undergraduate and postgraduate training in medical emergencies is recommended, as well as broader availability of emergency medical equipment in the dental office.
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Affiliation(s)
- Jacek Smereka
- Laboratory of Experimental Medicine and Innovative Technology, Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,The Witelon State University of Applied Sciences in Legnica, Legnica, Poland
| | - Marcin Aluchna
- Department of Conservative Dentistry, Medical University of Warsaw, Warsaw, Poland
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Travers A, Taylor K. Adrenaline use: The use of pre-filled adrenaline syringes in anaphylaxis kits. Br Dent J 2019; 226:85-86. [DOI: 10.1038/sj.bdj.2019.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Al-Hassan M, AlQahtani S. Preparedness of dental clinics for medical emergencies in Riyadh, Saudi Arabia. Saudi Dent J 2018; 31:115-121. [PMID: 30705575 PMCID: PMC6349958 DOI: 10.1016/j.sdentj.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 11/05/2022] Open
Abstract
Aim To assess knowledge, training of dental staff and the availability of emergency drugs and equipment in dental clinics, Riyadh, Saudi Arabia. Methods Cross-sectional survey was conducted in a random sample (N: 325) of governmental and private clinics in Riyadh, Saudi Arabia, between June-December 2016. Questions included Dentist’s specialty, age, years of experience, knowledge and preparedness to handle ME (level of training, types of emergency drugs and equipment available). Results One dentist from each clinic filled the questionnaire (100% of the sample), 19% of whom were general dentists. Medical history is taken orally by 86% of respondents before dental treatment and 12% take vital signs every visit. Of the surveyed clinics, 30% didn’t have emergency contact numbers available, 78% didn’t have an emergency protocol and only 54% have a medical emergency plan with 11% performing periodic office emergency drills. The most available emergency drug and equipment were Aspirin (53%) and Sphygmomanometer (86%). Oxygen delivery device was not available in 90% of the surveyed clinics. Conclusion There is an alarming inadequacy of clinic/staff preparation to deal with ME. Efforts should be made to increase the awareness of dentists to take needed precautions and prepare their clinics.
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Affiliation(s)
- Mona Al-Hassan
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sakher AlQahtani
- Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Vaughan M, Park A, Sholapurkar A, Esterman A. Medical emergencies in dental practice - management requirements and international practitioner proficiency. A scoping review. Aust Dent J 2018; 63:455-466. [DOI: 10.1111/adj.12649] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M Vaughan
- Faculty of Dentistry; College of Medicine and Dentistry; James Cook University; Smithfield Queensland Australia
| | - A Park
- Faculty of Dentistry; College of Medicine and Dentistry; James Cook University; Smithfield Queensland Australia
| | - A Sholapurkar
- Faculty of Dentistry; College of Medicine and Dentistry; James Cook University; Smithfield Queensland Australia
| | - A Esterman
- School of Nursing and Midwifery; University of South Australia; Adelaide South Australia Australia
- Australian Institute of Tropical Health and Medicine; James Cook University; Smithfield Queensland Australia
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Wald DA, Wang A, Carroll G, Trager J, Cripe J, Curtis M. An Office-Based Emergencies Course for Third-Year Dental Students. J Dent Educ 2018. [DOI: 10.1002/j.0022-0337.2013.77.8.tb05572.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- David A. Wald
- Department of Emergency Medicine and Medical Director; William Maul Measey Institute for Clinical Simulation and Patient Safety Temple University School of Medicine
| | - Alvin Wang
- Department of Emergency Medicine; Temple University School of Medicine
| | - Gerry Carroll
- Department of Emergency Medicine; Cooper University School of Medicine
| | | | - Jane Cripe
- William Maul Measey Institute for Clinical Simulation and Patient Safety Temple University School of Medicine
| | - Michael Curtis
- William Maul Measey Institute for Clinical Simulation and Patient Safety Temple University School of Medicine
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de Bedout T, Kramer K, Blanchard S, Hamada Y, Eckert GJ, Maupome G, John V. Assessing the Medical Emergency Preparedness of Dental Faculty, Residents, and Practicing Periodontists: An Exploratory Study. J Dent Educ 2018; 82:492-500. [PMID: 29717073 DOI: 10.21815/jde.018.058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 11/11/2017] [Indexed: 11/20/2022]
Abstract
With the increased number of elderly and medically compromised individuals receiving dental care and the presence of systemic comorbidities and associated treatment modalities in this patient population, it is imperative that dentists be prepared to manage a variety of medical emergencies. The aim of this study was to assess the knowledge of and preparedness to manage common medical emergencies of cohorts of practicing periodontists, specialty residents, and faculty members, both for comparative purposes and as an aid to refining a dental school's standardized case scenarios. The study, conducted in 2017, was designed for four groups of randomly selected participants with at least 20 in each group; the actual number of voluntary participants was 28 private practice periodontists, 22 residents in specialty programs, 21 specialist faculty members, and 24 general practice faculty members. Participants were asked to evaluate ten clinical emergency cases and identify the diagnosis and indicated intervention for each. Groups were also evaluated for differences among correct responses for each case. Overall, there were no statistically significant differences for number of correct diagnoses or interventions among the four groups. However, several cases had varying degrees of incorrect diagnoses and management across all groups. Participants who had recently graduated or were still in school were able to treat cases appropriately more often than the other participants. Further refinement of cases to assess provider preparedness to correctly diagnose and manage medical emergencies is needed, specifically establishing case-specific features and addressing areas of potential confusion before the cases are used for educational purposes.
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Affiliation(s)
- Tatiana de Bedout
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry
| | - Kyle Kramer
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry
| | - Steven Blanchard
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry
| | - Yusuke Hamada
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry
| | - George J Eckert
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry
| | - Gerardo Maupome
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry
| | - Vanchit John
- Tatiana de Bedout, DDS, is in private practice in Indianapolis, IN; this study was conducted while she was a resident, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; Kyle Kramer, DDS, MS, is Assistant Clinic Professor of Dental Anesthesiology, Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry; Steven Blanchard, DDS, MS, is Director of Graduate Periodontics, Indiana University School of Dentistry; Yusuke Hamada, DDS, MSD, is Clinical Assistant Professor, Department of Periodontics and Allied Dental Program, Indiana University School of Dentistry; George J. Eckert, MAS, is Biostatistician Supervisor, Department of Biostatistics, Indiana University School of Medicine; Gerardo Maupome, BDS, MSc, PhD, is Professor, Department of Social and Behavioral Sciences, and Associate Dean of Research, Richard M. Fairbanks School of Public Health, Indiana University; and Vanchit John, DDS, MSD, is Chair, Department of Periodontics and Allied Dental Programs, Indiana University School of Dentistry.
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Roy E, Quinsat VE, Bazin O, Lesclous P, Lejus-Bourdeau C. High-fidelity simulation in training dental students for medical life-threatening emergency. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e261-e268. [PMID: 28833993 DOI: 10.1111/eje.12284] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/13/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Any dental surgeon may be faced with a critical life-threatening emergency situation. In our university, all students in dentistry receive a standard course on emergency first aid. The aim of this prospective, comparative, single-centre study was to determine whether additional training on a high-fidelity patient simulator would improve student performance. METHODS After approval by an Ethical Committee and written informed consent, the students of the Simulation group (n=42) had full-scale high-fidelity training on a patient simulator SimMan 3G™ (3 hours by six students). They participated in pairs in two scenarios (airway obstruction, seizures, allergies, vasovagal syncope, asthma, chest pain). The first scenario was simple, and the second was a progression to cardiac arrest. Three months later, the Simulation group and the Control group (n=42) participated in a test session with two scenarios. The primary end point was the score at the test session (with a standardised scoring grill, direct observation and audio-video recording). Data were median and 25%-75% percentiles. RESULTS High-fidelity training strongly improved the score on the test obtained by the students of the Simulation group (146 [134-154]) which was much higher (P<.0001) than in the Control group (77 [67-85]). Technical as well as non-technical skills components of the scores were improved. In addition, performances of the Simulation group were increased between the training and the test. Simulation session was very positively assessed by the students. CONCLUSIONS The results support the systematic introduction of training to critical life-threatening emergency situations on high-fidelity patient simulators the dentistry curriculum. The impact on clinical practice in the dental office remains to be assessed.
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Affiliation(s)
- E Roy
- Laboratoire Expérimental de Simulation en Médecine Intensive de l'Université (LE SiMU), Nantes, France
- Service d'Odontologie Conservatrice et Pédiatrique, Centre de Soins Dentaires, C.H.U. Nantes, Nantes, France
| | - V E Quinsat
- Laboratoire Expérimental de Simulation en Médecine Intensive de l'Université (LE SiMU), Nantes, France
- Service d'Odontologie Restauratrice et Chirurgicale, Centre de Soins Dentaires, C.H.U. Nantes, Nantes, France
| | - O Bazin
- Laboratoire Expérimental de Simulation en Médecine Intensive de l'Université (LE SiMU), Nantes, France
- Service d'Anesthésie et de Réanimation Chirurgicale, Hôtel-Dieu Hôpital Mère Enfant, C.H.U. Nantes, Nantes, France
| | - P Lesclous
- Service d'Odontologie Restauratrice et Chirurgicale, Centre de Soins Dentaires, C.H.U. Nantes, Nantes, France
| | - C Lejus-Bourdeau
- Laboratoire Expérimental de Simulation en Médecine Intensive de l'Université (LE SiMU), Nantes, France
- Service d'Anesthésie et de Réanimation Chirurgicale, Hôtel-Dieu Hôpital Mère Enfant, C.H.U. Nantes, Nantes, France
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Al-Iryani GM, Ali FM, Alnami NH, Almashhur SK, Adawi MA, Tairy AA. Knowledge and Preparedness of Dental Practitioners on Management of Medical Emergencies in Jazan Province. Open Access Maced J Med Sci 2018. [PMID: 29531613 PMCID: PMC5839457 DOI: 10.3889/oamjms.2018.072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Medical emergencies are one of the most stressful situations the staff in a dental practice might encounter. The duty of care toward the attending patients obligates suitable preparedness to provide the necessary care if such emergencies ensue. Unfortunately, we found that 22% of the investigated dental clinics had no emergency kit available. Only 38% of the interviewed dentists felt confident to perform CPR, and 18% had no confidence to manage any medical emergency. An MCQ test of 20 questions examining the dentists’ knowledge in medical emergencies was distributed, and the level of knowledge was found to be suboptimal. The average score of the interviewed dentists was 10.87 out of 20. Experience and specialty training had a negligible effect on the level of knowledge.
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Affiliation(s)
- Ghassan M Al-Iryani
- College of Dentistry - Oral & Maxillofacial Surgery Jazan, Jazan, Saudi Arabia
| | - Fareedi Mukram Ali
- College of Dentistry - Oral & Maxillofacial Surgery Jazan, Jazan, Saudi Arabia
| | - Naima H Alnami
- College of Dentistry - Oral & Maxillofacial Surgery Jazan, Jazan, Saudi Arabia
| | - Sahar K Almashhur
- College of Dentistry - Oral & Maxillofacial Surgery Jazan, Jazan, Saudi Arabia
| | - Maha A Adawi
- College of Dentistry - Oral & Maxillofacial Surgery Jazan, Jazan, Saudi Arabia
| | - Abrar A Tairy
- College of Dentistry - Oral & Maxillofacial Surgery Jazan, Jazan, Saudi Arabia
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Pinsky HM, Le JM, Sweier DG, Marti K. Dental students' ability to locate emergency equipment-lessons learned from aviation. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e19-e25. [PMID: 28019067 DOI: 10.1111/eje.12251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the dental student's ability to locate medical emergency equipment/items at the University of Michigan School of Dentistry clinic. METHODS A total of 138 second-year dental students (traditional group) participated in this study as part of a simulation-based medical emergencies rotation course held during the winter term of 2014 and 2015. Without prior training, students were tested on their ability to locate nine predetermined items on the clinic floor using a self-reported checklist. Six months later, a convenience sample of 18 students (novel group) from the same cohort were later trained on their location and retested individually. RESULTS Of the 138 students tested, only 10.14% students could locate seven of the nine items when compared to 100% in the novel group. Only 5.07% of students in the traditional group could locate all items initially, compared with 72.22% students in the novel group. CONCLUSION Whilst our students have lecture-based knowledge about medical emergencies, the results of our study identified a gap of knowledge of emergency equipment/item location amongst students. Therefore, an intervention performed with a similar group of second-year dental students supported that proper training may be used to achieve retention of knowledge. Based on our "novel group" results, we have incorporated targeted training in the dental curriculum that leads to students being better prepared in locating emergency equipment/items. This study suggests that other populations, such as faculty or staff, may also benefit from hands-on training.
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Affiliation(s)
- H M Pinsky
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - J M Le
- University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - D G Sweier
- Department of Cariology, Restorative Sciences & Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - K Marti
- Department of Oral and Maxillofacial Surgery/Hospital Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Sooch S, Kaur A, Ahmed B. A ten year experience of medical emergencies at Birmingham Dental Hospital. Br Dent J 2018; 224:89-91. [PMID: 29327720 DOI: 10.1038/sj.bdj.2017.1000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 11/09/2022]
Affiliation(s)
- S Sooch
- Birmingham Dental Hospital and School of Dentistry, 5 Mill Pool Way, Birmingham B5 7EG, United Kingdom
| | - A Kaur
- Birmingham Dental Hospital and School of Dentistry, 5 Mill Pool Way, Birmingham B5 7EG, United Kingdom
| | - B Ahmed
- Birmingham Dental Hospital and School of Dentistry, 5 Mill Pool Way, Birmingham B5 7EG, United Kingdom
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Rubin ME, Hansen HJ. An Emergency Simulation Course in a Postdoctoral General Dentistry Program: The New York Presbyterian/Weill Cornell Medicine Experience. J Dent Educ 2017; 81:1345-1350. [PMID: 29093148 DOI: 10.21815/jde.017.094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/14/2017] [Indexed: 11/20/2022]
Abstract
Dentists can encounter life-threatening medical emergencies during the provision of routine dental care and must therefore be comfortable with the management of these emergencies. High-fidelity simulation has been used routinely in medical and surgical training and is a recognized and effective educational and assessment tool. The aim of this study was to develop and evaluate a new high-fidelity simulation training course in medical emergency management for residents in the General Practice Residency program at New York Presbyterian/Weill Cornell Medicine. In academic years 2014-16, first-year GPR residents were required to take a simulation course covering medical emergency scenarios that are commonly encountered in the dental office. The course involved a team approach to emergency management with active participation by faculty and residents and with each training session followed by feedback and a formal review of the emergencies covered. Evaluation was achieved through completion of questionnaires by the residents following each session. A total of 14 residents (seven in each year) participated, completing 78 questionnaires in the two-year period. They gave the course an overall rating of 4.91 on a scale from 1 to 5, indicating strong agreement with the utility of the course as a learning tool in medical emergency management training. This course is now fully integrated into the GPR educational program at this institution and is a successful component of the emergency medicine curriculum.
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Affiliation(s)
- Marsha E Rubin
- Dr. Rubin is Assistant Professor of Surgery, Division of Dentistry, Oral & Maxillofacial Surgery, Weill Cornell Medicine, as well as Director of Dentistry, New York Presbyterian/Weill Cornell Medicine and Chief of Dental Medicine, New York Presbyterian Queens; Dr. Hansen is Assistant Professor of Surgery, Division of Dentistry, Oral & Maxillofacial Surgery, Weill Cornell Medicine and Program Director, General Practice Residency, New York Presbyterian/Weill Cornell Medicine
| | - Heidi J Hansen
- Dr. Rubin is Assistant Professor of Surgery, Division of Dentistry, Oral & Maxillofacial Surgery, Weill Cornell Medicine, as well as Director of Dentistry, New York Presbyterian/Weill Cornell Medicine and Chief of Dental Medicine, New York Presbyterian Queens; Dr. Hansen is Assistant Professor of Surgery, Division of Dentistry, Oral & Maxillofacial Surgery, Weill Cornell Medicine and Program Director, General Practice Residency, New York Presbyterian/Weill Cornell Medicine.
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Mac Giolla Phadraig C, Ho JD, Guerin S, Yeoh YL, Mohamed Medhat M, Doody K, Hwang S, Hania M, Boggs S, Nolan A, Nunn J. Neither Basic Life Support knowledge nor self-efficacy are predictive of skills among dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:187-192. [PMID: 26991795 DOI: 10.1111/eje.12199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/23/2016] [Indexed: 06/05/2023]
Abstract
AIM Basic life support (BLS) is considered a core competence for the graduating dentist. This study aimed to measure BLS knowledge, self-efficacy and skills of undergraduate dental students in Dublin. METHODS This study consisted of a cross-sectional survey measuring BLS knowledge and self-efficacy, accompanied by a directly observed BLS skills assessment in a subsample of respondents. Data were collected in January 2014. Bivariate correlations between descriptive and outcome variables (knowledge, self-efficacy and skills) were tested using Pearson's chi-square. We included knowledge and self-efficacy as predictor variables, along with other variables showing association, into a binary logistic regression model with BLS skills as the outcome measure. RESULTS One hundred and thirty-five students participated. Almost all (n = 133, 98.5%) participants had BLS training within the last 2 years. One hundred and four (77%) felt that they were capable of providing effective BLS (self-efficacy), whilst only 46 (34.1%) scored >80% of knowledge items correct. Amongst the skills (n = 85) subsample, 38.8% (n = 33) were found to pass the BLS skills assessment. Controlling for gender, age and skills assessor, the regression model did not identify a predictive relationship between knowledge or self-efficacy and BLS skills. CONCLUSIONS Neither knowledge nor self-efficacy was predictive of BLS skills. Dental students had low levels of knowledge and skills in BLS. Despite this, their confidence in their ability to perform BLS was high and did not predict actual competence. There is a need for additional hands-on training, focusing on self-efficacy and BLS skills, particularly the use of AED.
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Affiliation(s)
- C Mac Giolla Phadraig
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - J D Ho
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - S Guerin
- Centre for Disability Studies, UCD, Belfield Co., Dublin, Ireland
| | - Y L Yeoh
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - M Mohamed Medhat
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - K Doody
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - S Hwang
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - M Hania
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - S Boggs
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - A Nolan
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
| | - J Nunn
- Department of Child and Public Dental Health, Trinity College Dublin, Dublin Dental University Hospital, Dublin, Ireland
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Čuković-Bagić I, Hrvatin S, Jeličić J, Negovetić Vranić D, Kujundžić Tiljak M, Pezo H, Marks L. General dentists' awareness of how to cope with medical emergencies in paediatric dental patients. Int Dent J 2017; 67:238-243. [PMID: 28422288 DOI: 10.1111/idj.12286] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND General dentists (GDs) should be aware of the symptoms, signs, diagnoses and treatment of medical emergencies in paediatric patients. AIM To evaluate the knowledge of GDs in coping with medical emergencies, and to identify whether they are confident to diagnose and treat medical emergencies in paediatric patients. DESIGN The questionnaire was conducted immediately before the beginning of national dental meetings and continuing education seminars in Croatia, attended by the GDs, in order to obtain a representative sample. RESULTS Of a total of 498 GDs who returned the questionnaire with valid data, 51.2% reported that a medical history was regularly taken. A high proportion (81.3%) of the GDs had never received any basic life support (BLS) training and education for paediatric patients during their undergraduate studies. After graduation, this value rose to 86.1% of GDs. However, more than two-thirds (68.7%) had experienced some emergency situation in their practice. The most frequent emergency was vasovagal syncope (83.6%) and the most rare was cardiac arrest (8.2%). One-fifth (20.5%) of GDs experienced some emergency but could not make a diagnosis. The more BLS training undergone by a GD, the more self-confident s/he felt in an emergency situation. CONCLUSIONS Most GDs have a lack of knowledge to cope with medical emergencies in paediatric patients, and do not feel confident to diagnose and treat emergency situations in children. It is suggested that adequate training and education should be provided for all GDs to address this shortcoming.
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Affiliation(s)
- Ivana Čuković-Bagić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.,Department of Dental Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Sandra Hrvatin
- Department of Paediatric Dentistry, School of Medicine, University of Rijeka, Rijeka, Croatia
| | | | - Dubravka Negovetić Vranić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.,Department of Dental Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Mirjana Kujundžić Tiljak
- Department of Medical Statistics, Epidemiology and Medical Informatics, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Hrvoje Pezo
- Croatian Chamber of Dental Medicine, Zagreb, Croatia
| | - Luc Marks
- Centre of Special Care in Dentistry, PaeCoMeDiS, Ghent University Hospital, Gent, Belgium
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