With so many different areas of dentistry to focus on, the importance of first aid and dealing with medical emergencies can get overlooked in dental school. Medical emergencies happen from time to time in a dental practice and can range from hyperventilation (panic attacks) and syncope (fainting) to life threatening events such as cardiac arrest and anaphylaxis.

Having staff trained in the basics of first aid and handling medical emergencies big and small can provide that crucial intermediary step in treating patients before outside help arrives and can go a long way to a successful outcome for the patient.

What is First Aid?

First aid is immediate medical assistance given to a person who is injured or suddenly taken ill. Dental practice owners are legally responsible for ensuring patients and employees receive immediate medical attention if they are taken ill or injured on the premises. This covers a wide range of scenarios from simple reassurance following a minor mishap to dealing with a life-threatening medical emergency in the practice.

Recognising different types of medical emergencies and knowing what immediate action to take is something that all members of the dental team should be able to do. Here are some of the most common types of medical emergencies you might find happen in a dental setting:

Asthma

Most patients with asthma will know they have it and have this noted down in their medical file. Asthma attacks can usually be recognised by the patient having difficulty breathing or making wheezing sounds when exhaling. Inhalers should be on hand in the practice to give to the patient in case they do not have theirs.

Hyperventilation

Hyperventilation means breathing in more than your body needs. Most people refer to this as a panic attack. Patients most likely to suffer from hyperventilation at the dentist will likely have experienced panic attacks in the past and have this recorded in their medical history.

What level of training is legally required?

According to the GDC, all registered dental professionals should be trained in dealing with medical emergencies and should have up-to-date evidence of capability. The GDC says that all dental professionals must complete at least 10 hours of medical emergencies training and recommends that at least two hours of this training is carried out every year.

Areas normally covered in such training includes:

• Basic Life Support (BLS)
• Use of an AED
• Choking
• Management of acute anaphylaxis
• Use of Emergency Equipment (oxygen, airway adjuncts and drugs)
• Cardiac Arrest Rhythms
• Recognising and responding appropriately to asthma, diabetes, fainting, epilepsy and myocardial infarction

Does my dental practice need a risk assessment?

All dental practices need a risk assessment in accordance with the Health and Safety (First-Aid) Regulations 1981. The risk assessment should take into account the hazards and risks associated with the activities taking place in your dental practice.

Does my dental practice need a trained first-aider?

The size of a dental practice will determine whether a trained first-aider is needed or not. The BDA offers the following guidance on this subject:

• If you have less than five workers, you should have at least one appointed person to look after first aid.
• If you have five or more workers, you might want to consider having at least one person trained in basic 'emergency first aid at work' (EFAW – a one-day course).
• Dental practices with more than 50 workers, must have at least one first-aider who has completed the first aid at work (FAW – three-day course).