I recently lectured at the Hinman Dental Meeting in Atlanta, GA. My host shared a story with me about a recent emergency in his dental office. He had the privilege of having another dentist and his wife as patients in the practice. They were in for the wife’s dental visit and he invited the husband back into the operatory to take a look at her recent radiographs. He reports he was cheerful, upbeat and looked healthy and spry as he followed him back to the operatory. Once in the room the husband suddenly hit the floor, turned deathly pale and had no pulse. The office sprang into action and was able to restart his heart before the paramedics arrived. Sadly, he did not survive once at the hospital due to extensive damage to his heart. Later the paramedics called the office to share a compliment: They had never seen an office so prepared, where everyone did their role perfectly during a call to a business emergency.
Each member of their team not only knew where the AED and emergency supplies were, like oxygen and medications – they each had a specific role to play if an emergency happened, to streamline the process, as every second counts. For example, one member of the team retrieves the AED, another calls 911, a third goes out front and stands to flag down the paramedics when they arrive and direct them to the correct office. The doctor and another team member works together to perform CPR and use the AED, and a last team member is there as backup in case they needed anything or someone had to step away.
I came home and we scheduled a team meeting to practice our emergency protocol and to assign each team member a designated role. I hope to practice until I retire and not need all the time we have spent on being prepared. However, if we are confronted with an emergency I would like to know we did all we could in the best way possible. If you haven’t thought about it in awhile it is time to check your emergency supplies and preparation. I have a list of things to cover at our upcoming meeting. What else is on your emergency preparations to do list?
- AED new batteries
- AED new pads
- AED location and use
- Oxygen supplies, location and use
- Emergency kit, updated and all meds current
- CPR training for every team member
- Emergency role designation
- Emergency practice runs
It’s a great idea to run a drill with the dentist as the victim of the emergency because more likely than not, the dentist is who will have a medical emergency. In my office, the hygienist steps in as the leader without me beimg in charge. How will the patients that I am actively treating be provisionalized? For example, it’s a good idea to teach an auxiliary how to smear glass ionomer on a crown prep or, better yet, have a contingency plan in place with a nearby colleague for urgent stabilization.
Communication with patients should also be scripted in advance. For example, often a basic explanation is needed when patients see an ambulance pull up, especially when your request for no sirens and flashets is ignored. If it is your protocol to follow the patient to the hospital, or if you have to get the ride in the ambulance yourself, how will the immediately following patients be rescheduled?
One item to add to your emergency protocol…. a Ziploc baggie kept close in which the primary assistant should place all anesthetic cartridges used on the victim during the appointment. When EMS arrive, the victim’s name, birthday, and date of the emergency should be written on the baggie with a Sharpie, and the baggie with enclosed cartridges should be given to the medic to go with the patient to the ER.
Thanks Kevin, great info I will add this to our protocol.
Lee
Kevin, that’s a great idea! You want to make sure everyone is comfortable in all roles because you never know who will need help, who will be out of the office, etc. There are so many little details that have to get done right and no time for anyone to second guess themselves.