Guidance surrounding medicine and dentistry is never static – it can be so hard to keep on top of the changes. Some practitioners delegate this responsibility to staff members or don’t undertake the relevant CPD at all. Dr Annalene Weston, dentolegal adviser at Dental Protection, explores this in the context of a recent case

Medical emergencies can and will happen in dental practice, but are you prepared for them?  There are two key things that every practitioner can do to ensure that they are:

Undertake annual CPR updates

The key dental guidance for this comes from the NZDA, which sets the minimum requirements for each division of registrants in the document Code of Practice for Medical Emergencies in Dental Practice:

Resuscitation training

4.7. The NZRC provides graduated levels of resuscitation training. CORE Level 4 has been developed as the foundation level of resuscitation training appropriate for New Zealand’s health professionals.

4.8. Oral health practitioners must successfully complete the following minimum levels of resuscitation training:

A review of the current guidelines from the New Zealand Resuscitation Council reveals: “Repeated refresher training is needed for individuals who are not performing resuscitation on a regular basis.  All those trained in CPR should refresh their CPR skills at least annually.”[1]

The Code of Practice for Medical Emergencies also sets out the equipment and drugs that must be readily available for use.[2]

Case study

These guidelines assist practitioners in saving lives.

A member called Dental Protection recently to make a notification regarding an incident at practice. A regular patient, with a documented cardiac issue managed by a pacemaker and medication, attended the practice for the insertion of a crown. Less than 1ml of lignocaine was administered by infiltration and, midway through the procedure, the patient had a cardiac incident and went into defibrillation.

Luckily, the member had recently attended an update on medical emergencies with his staff and had revised the practice protocols and updated their medical kit in accordance with this. As they had all had the opportunity to practise the management of a medical emergency, everyone knew what to do. 000 was called, oxygen was administered and CPR was performed until the paramedics arrived. A pulse was re-established and the patient survived, without brain damage or any other adverse outcome.

Dentolegal adviser’s perspective

This good news story could have so easily been a tragedy. The importance of regular updates of all knowledge relevant to dental practice should not be overlooked and, in this instance, a life was saved.

DO

Keep an eye out for updates to the guidance and standards

Undertake regular CPD in all aspects of practice

Review your practice medical emergency plan

Ensure your staff have regular updates in matters relevant to them too.

DON’T

Forget to schedule your practice CPR refresher

Forget to check the expiry dates of emergency drugs

Forget to maintain any emergency equipment.

[1] New Zealand Resuscitation Council – Guideline 10.1, Basic Life Support Training. March 2013

[2] Code of Practice for Medical Emergencies in Dental Practice – September 2014 – Dental Council of New Zealand  https://www.dcnz.org.nz/assets/Uploads/Consultations/2014/Att2-Medical-Emergencies-Code-of-Practice.pdf