• Title/Summary/Keyword: Dental emergency care

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Cognition of registered nurse on emergency treatment for oral and maxillofacial injury in Jeju province (제주 지역 간호사의 구강 악안면 영역 손상에 대한 응급 처치 인식도)

  • Lee, Byoung-Jin;Song, Hyo-Jeong;Lim, Gil-Chai;Kahm, Se-Hoon;Kim, Sung-Joon
    • The Journal of the Korean dental association
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    • v.50 no.12
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    • pp.763-770
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    • 2012
  • The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question 'education time on dentistry in formal education' that marked '0 hour' and '1-3 hours' were 73.3% and 20.0%, respectively. The question 'refresher training class on dentistry' that marked '0 hour' and '1-3 hours' were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question 'reduction of temporo-mandibular joint(TMJ)'($1.67{\pm}0.857$), 'fixation of dislocated TMJ'($1.70{\pm}0.853$) and 'post-avulsed tooth treatment'($1.78{\pm}0.774$) by 5-point Likert scale. Likewise, the scores were $2.02{\pm}0.806$ in the question 'treatment of maxillofacial trauma', $2.76{\pm}1.061$ in the question 'emergent care of avulsed tooth', $2.70{\pm}1.095$ in the question 'treatment time of avulsed tooth' and $2.79{\pm}1.056$ in the question 'mouth guard', respectively. Compared to EMT, results of RN showed a statistically lower figure(p<0.05) in all items compared except the question 'medicine control', and the question 'doctor care in emergency room' was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.

Primary Closure of Deep Penetrating Wounds under Local Anesthesia with Dental Lidocaine HCL 28 Ampules in Maxillofacial Regions -Report of two cases - (치과용 Lidocaine 28 앰플로 국소마취 하에 1차 봉합한 악안면 심부 관통성 열창 -증례 보고-)

  • Kim, Jong-Bae;Yoo, Jae-Ha
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.1 no.1 s.1
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    • pp.26-31
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    • 2001
  • The wide deep penetrating wound of maxillofacial region should be early closed under emergency general anesthesia for the prevention of complications of bleeding, infection, shock & residual scars. But, if the emergency general anesthesia wound be impossible because of pneumoconiosis, obstructive pulmonary disease & hypovolemic shock, early primary closure should be done under local anesthesia by use of much amount of the anesthetic solution. The maximum dose of dental lidocaine (2% lidocaine with 1 : 100,000 epinephrine) is reported to 7 mg/kg under 500 mg (13.8 ampules) in normal adult. But the maximum permissible dose of dental lidocaine can be changed owing to the general health, rapidity of injection, resorption, distribution & excretion of the drug. The blood level of overdose toxicity is above $4.0{\mu}g/ml$ in central nervous & cardiovascular system. The injection of dental lidocaine 1-4 ampules is attained to the blood level of $1{\mu}g/ml$ in normal healthy adult. The duration of anesthetic action in the dental 2% lidocaine hydrochloride with 1 : 100.000 epinephrine is 45 to 75 minutes and the period to elimination is about 2 to 4 hours. Therefore, authors selected the following anesthetic methods that the first injection of 6 ampules is applied into the deeper periosteal layer for anesthetic action during 1 hour, the second injection into the deeper muscle & fascial layer, the third injection into the superficial muscle and fascial layer, the fourth injection into the proximal skin & subcutaneous tissue and the fifth final injection into the distal skin & subcutaneous tissue. The total 26-28 ampules of dental lidocaine were injected into the wound as the regular time interval during 5-6 hours, but there were no systemic complications, such as, agitation, talkativeness, convulsion and specific change of vital signs and consciousness.

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A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY VISITING SANG-GYE PAIK HOSPITAL EMERGENCY ROOM. (상계백병원 응급실에 내원한 구강악안면외과 응급환자에 대한 임상적 연구)

  • Baik, Jee-Seon;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Choi, Min-Hye;Kwon, Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.561-566
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    • 2008
  • This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.

Knowledge According to Learning Experiences of CPR for Health Occupation College Students (대학생의 심폐소생술에 대한 교육경험에 따른 지식 - 일 광역시를 중심으로 -)

  • Uhm, Dong-Choon;Jun, Myung-Hee;Hwang, Ji-Young;Choi, Jee-Yae
    • The Journal of Korean Academic Society of Nursing Education
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    • v.14 no.1
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    • pp.138-146
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    • 2008
  • Purpose: The first responder's role during a cardiac arrest scene is to initiate CPR. The AHA has recognized and included the first responder's role for improving the survival rate of cardiac arrest patients. Health personnel working in nursing, emergency care, dental hygiene, radiology, and ocular optics frequently confront sudden cardiac arrest while working. This study was to identify the relationship between the educational experience and recognition with the level of knowledge about CPR for college students. Method: Five hundred forty college students enrolled in the department of nursing science, radiological technology, ocular optics, emergency medical technician, or dental hygiene in Daejeon city were surveyed. The tool used was CPR knowledge developed by the authors based on a literature review including 2005 AHA's CPR guideline. Result: The higher educational experience of CPR was, the higher the level of knowledge. The knowledge of the students in nursing or emergency medical technician was higher than students in dental hygiene, radiology, and ocular optics. Conclusion: CPR class should be included in the curriculum for college students in order to improve their accuracy as a first responder to cardiac arresting patients.

Protocol for management of pregnant patients requiring emergency minor oral surgical procedures: a prospective study in 52 patients

  • Ajinath Nanasaheb Jadhav;Shushma G;Uzma Hamidullah Siddiqui;Minal Sharma;Yaseer Irfan Shaikh;Pooja Raosaheb Tarte
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.1
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    • pp.21-29
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    • 2023
  • Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

Crown removal and endodontic drainage as a last method in active gingival bleeding with liver cirrhosis and periodontitis: a case report (간경화증과 치주염으로 과도한 치은출혈을 보인 응급환자에서 최후 지혈방법으로 치관제거와 치근관 배농술: 증례보고)

  • Choi, Young-Su;Kang, Sang-Hoon;Kim, Moon-Key;Lee, Chun-Ui;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.3
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    • pp.221-227
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    • 2010
  • The most common local cause of active gingival bleeding is the vessel engorgement and erosion by severe inflammation. Abnormal gingival bleeding is also associated with the systemic disturbances. Hemorrhagic disorders in which abnormal gingival bleeding is encountered include the following: vascular abnormalities (vitamin C deficiency or allergy), platelet disorders, hypoprothrombinemia (vitamin K deficiency resulting from liver disease), and other coagulation defects (hemophilia, leukemia). There are many conventional methods for gingival bleeding control, such as, direct pressure, electrocoagulation, direct suture, drainage, application of hemostatic agents and crushing and packing. If the active continuous gingival bleeding is not stopped in spite of the application of all conventional bleeding control methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency dental care. This is a case report of active gingival bleeding care via dental crown removal and emergency primary endodontic drainage as a last method in liver cirrhosis patient with advanced periodontitis.

Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist (소아치과의사를 위한 심폐소생술과 소아고급생명구조술)

  • Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.243-255
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    • 2017
  • Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

Factors Affecting Patient Satisfaction of Dental Services Organizations (치과의료서비스에 대한 환자만족 영향원인 -경남 일부 지역 치과의원을 중심으로-)

  • Lee, Eun-Sook;Park, Jeong-Ran;Choi, Mi-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.2
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    • pp.247-261
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    • 2005
  • The main objective of this study is to investigate the factors affecting patient satisfaction, repeat-use intention, and inducement intention for providing the suggestion for patient-oriented management of dental services organizations. For this study, the patient satisfaction model including 14 facets of satisfaction factors such as distance(time/location), human services(dentist-hygienist), treatment results, and facilities(convenient facilities/parking lot) was examined. Data were collected from 196 patients who visiting the same dental services organization more than two times of ten dental clinics at Kyeongsangnam-do area using self-administered questionnaire. Major results of the empirical analysis are as follows: First, patient satisfaction, repeat-use intention, and inducement intention were significantly correlated with gender, age, economic conditions among patients of dental clinics. Second, kindness of hygienist, treatment results, kindness of receptionist, waiting time, emergency medical services, and right-fee for services were found to have significant influence on dental services organizations. These research findings suggest that improvement of service quality in dental care and advancement in treatment ability of dentist and hygienist are very important to improve patient satisfaction and patient-oriented service system in dental services organizations.

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Implementation of contextualized, emergency management cognitive aids in a periodontics clinic

  • Siemens, Mikaela J.;Rice, Andi N.;Jensen, Trenton F.;Simmons (Muckler), Virginia C.
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.3
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    • pp.227-236
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    • 2021
  • Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.