• oxygen compressed USP

• Samaritant PAD (Blue)

• Hearsine Samaritan PAD Defibrillator (Yellow)

Where are they Located:

• 1- dental hygiene station 8

  2-front dental hygiene clinic

  3-dental hygiene class lab

• PADS are hanging on the oxygen Tank

1. Stay calm

2. Stay with the patient and notify the closest student or faculty member (Rescuer #2) by saying "CODE RED"

3. Begin the CAB's (Circulation, Airway, Breathing) of Basic Life Support (BLS)

Rescuer #2: Notification and Equipment Retrieval

1. If Rescuer #2 is a student, notify the RDH instructor or DDS immediately

2. Bring the oxygen tank and emergency mobile cart from the instructor station

3. Dial 9-1-1 if the clinic instructor or supervising dentist indicates a need

   • Provide the 911 operator with:

     • Your name

     • Your phone number: (713) 395-5454

     • Details of the emergency

     • Location: Pima Medical Institute Dental Hygiene Clinic, 11125 Equity Drive, Suite 100, Houston, TX 77041

4. Go to the entrance to meet the EMS and guide them to the emergency site

Rescuer #1: Assistance and Documentation

1. Once the faculty member arrives, continue to assist them

2. Help with BLS and monitor vital signs

3. Verify that the DDS and EMS have been notified if the instructor is present

4. Record in writing a description of the emergency, the time it occurred, signs, symptoms, and vital signs

5. Notify the Program Director once the situation allows

Emergency Follow-up

1. All persons involved (Dentist, Instructor, Student[s]) will meet to discuss:

   • Description and cause of the emergency

   • Corrective actions to prevent future situations, if applicable

   • Complete an accident/incident report and submit it to the Program Director

2. Call the patient to determine their current health status and document the discussion in the patient chart

Fire Emergency Procedures

Preparation and Training

1. Students and staff are trained on the location and proper use of fire extinguishers and the fire evacuation plan during orientation

2. Students are instructed to stay together during a fire evacuation

Immediate Action on Scene

1. Evacuate the area and activate the Emergency Response System by dialing 9-1-1 from a safe location

2. Use fire extinguishers at your discretion, considering time and safety, and only after evacuating the area

Evacuation Process

1. Exit via the nearest safe evacuation route

2. Evacuation routes are posted near the door of each classroom

3. Instructors ensure all students have evacuated and close the classroom door before exiting the building

Call to Action

Review and update your facility's emergency plan regularly to ensure it meets the latest safety standards and best practices. Provide comprehensive training to all staff and students to ensure they are prepared to respond quickly and appropriately in an emergency situation.

• ASA (American Society of Anesthesiologists) Physical Status Classification System

• Assesses a patient's physical condition before anesthesia or surgery

• Ranges from ASA I (healthy patient) to ASA VI (brain-dead patient)

  • ASA I: Normal healthy patient

  • ASA II: Mild systemic disease

  • ASA III: Severe systemic disease

  • ASA IV: Severe systemic disease that is a constant threat to life

  • ASA V: Moribund patient who is not expected to survive without the operation

  • ASA VI: Brain-dead patient whose organs are being removed for donor purposes

Locating ASA Classifications in the Clinic Manual

• ASA classifications should be clearly defined and documented in the clinic's emergency procedures manual on station 8

• A medical referral is a request from one healthcare provider to another for the evaluation or treatment of a patient.

• Referrals typically involve the transfer of care from one provider to another.

What is a Medical Consult?

• A medical consult is a request for a healthcare provider to provide their expertise and recommendations on a specific aspect of a patient's care.

• Consults typically involve the primary care provider seeking input from a specialist or subspecialist.

1- dental hygiene station 8

2-front dental hygiene clinic

3-dental hygiene class lab

Medical Emergency Simulations​

• Person 1 – Stays with patient and performs emergency treatment (usually dentist)​

• Person 2 – Assists P1, take vitals, admin oxygen, records events and time of medication ​

• Person 3 – Retrieves emergency kit, prepares emergency drugs​

• Person 4 – Makes necessary phone calls (front office staff)​

• Chlorpheniramine (mild allergy)​: used for histamine blocker for allergic reaction with dermatologic signs like urticaria (red welts) and pruritus (itching) and respiratory symptoms like (wheezing)

• Aspirin (MI)​: used or reducing myocardial infarction and reducing moderate pain. 2 baby aspirins given to patient with pain

• Lorazepam (seizures or hyperventilation)​: used for seizures or hyperventilation and also will cause skeletal muscle relaxation. Adult dose 4mg

  
  

An extremely high blood pressure reading without target end organ damage​. Newly diagnosed hypertension, poor controlled blood pressure, or noncompliant with therapy​ Headache (moderate to severe)​ Anxiety​ Shortness of breath​ Tinnitus​ Edema​ Epistaxis (nosebleed)​ BP greater than 180/110​

Treatment: REPAIR

R: Recognize S & S: stop procedure: retake BP

E: Evaluate level of consciousness

P: If conscious-seat upright: if unconscious supine

A: Activate CABs/CPR

I: Contact EMS: monitor BP every 5 mins: administer 4-6L O2 (if patient complains of dyspnea)

R: Refer to ER

Extremely high BP with target end organ damage​, Target end organ damage:​ Aortic dissection​, Cerebral infarction or hemorrhage​, Myocardial infarction​, Renal insufficiency, Symptoms–similar to MI or CVA make it difficult to determine emergency:​ Sudden increase in BP >180/110; often as high as 220/140​, Dyspnea​, Chest pain​, Dysarthria​, Weakness​, Altered consciousness​, Visual loss​, Seizures​, Nausea/vomiting, Eventually coma​

Treatment​:

• Treat end organ damage (i.e. MI or CVA).​

• Treat hypertension secondarily.​

• Seat patient upright.​

• Contact EMS.​

• Monitor vital signs.​

• Administer O2 4–6 liters/minute.​

• Drugs should be administered by medical personnel in hospital setting​

• Usually reduction in baseline systolic or diastolic BP of 15–20 mmHg​

  
  

Medications:

• Often caused by medications (antihypertensive)​

• Can lead to shock​

Treatment:​

• Position supine with feet raised.​

• Assess airway.​

• Administer O2 4–6 liters/minute.​

• Monitor vital signs.​

• If no improvement, contact EMS.​

• Normally hypotensive individuals​

Medications:

• Medications (antihypertensive)​

Conditions:

• Postural hypotension​

• Sudden drop in BP due to change in body position​

• Usually from supine to sitting or standing​

• Dizziness or loss of consciousness may occur​

• Etiologies​

• Prolonged supine positioning​

• Illness​

• Smile- they can hear your enthusiasm when you speak if you smile 

• Identify yourself

• Explain the purpose of your call

• Have all of the information ready when you call (dates and times for an appointment or patient’s information for a consultation/inquiry)

• Leave your contact information

• Thank them

• Document the phone call and who you spoke with in clinical notes.

• Medical consultation:

  - Hello, this is _____________ a dental hygiene student at Pima Medical Institute. I am calling regarding a mutual patient, __________. He/she states on his/her medical history that he/she has medical condition. We would like to clarify what type of dental treatments he/she may receive. Our clinic policy is to have a medical consultation form in his/her chart. I have a HIPAA release form as well that I will send. Is there a fax number or email address that I can send this to? I appreciate your help and if you have any questions, our number is 713-395- 5454. Thank you and have a nice day