Medicine /BDS2 OSCE Prep - Medical History Taking/Emergencies OSCE
List FOUR emergency drugs* essential for every dental practise:
GTN spray Adrenaline Salbutamol Inhaler Aspirin (300mg tablets)
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Term
Definition
List FOUR emergency drugs* essential for every dental practise:
GTN spray Adrenaline Salbutamol Inhaler Aspirin (300mg tablets)
List FOUR emergency pieces of equipment* essential for every dental practise:
Oxygen face mask & tubing External defibrillator Pulse oximeter Blood glucose measurement device
A patient appears to go into anaphylaxis shock in the dental chair, what steps would you follow?
call 999, state anaphylaxis lie flat, administer oxygen 15litres/minute administer adrenaline 500 micrograms IM repeat adrenaline at 5 minute interval...
A 50 y/o patient appears to go into anaphylaxis shock in the dental surgery, you decide to administer a drug to help. What drug & dosage would you use?
ADRENALINE 500 micrograms (0.5mls 1:1000) IM may be repeated at 5 minute intervals until an adequate response is achieved
A patient within the dental practise becomes increasingly breathless & wheezy, they reveal to you that they suffer from asthma. What do you do?
sit upright and follow patients asthma plan if they have it if not administer 2 puffs of Beta 2 Bronchodilator inhaler such as salbutamol if no respon...
Why would GTN spray need to be used in the dental practise? What dose?
angina or suspected heart attack 2 sprays (sublingually) may be repeated
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Term | Definition |
---|---|
List FOUR emergency drugs* essential for every dental practise: | GTN spray Adrenaline Salbutamol Inhaler Aspirin (300mg tablets) |
List FOUR emergency pieces of equipment* essential for every dental practise: | Oxygen face mask & tubing External defibrillator Pulse oximeter Blood glucose measurement device |
A patient appears to go into anaphylaxis shock in the dental chair, what steps would you follow? | call 999, state anaphylaxis lie flat, administer oxygen 15litres/minute administer adrenaline 500 micrograms IM repeat adrenaline at 5 minute intervals until adequate response |
A 50 y/o patient appears to go into anaphylaxis shock in the dental surgery, you decide to administer a drug to help. What drug & dosage would you use? | ADRENALINE 500 micrograms (0.5mls 1:1000) IM may be repeated at 5 minute intervals until an adequate response is achieved |
A patient within the dental practise becomes increasingly breathless & wheezy, they reveal to you that they suffer from asthma. What do you do? | sit upright and follow patients asthma plan if they have it if not administer 2 puffs of Beta 2 Bronchodilator inhaler such as salbutamol if no response/life threatening: call 999, oxygen 15Litres/Min, via spacer give one puff at a time of salbutamol (every 60 secs, max 10 puffs) |
Why would GTN spray need to be used in the dental practise? What dose? | angina or suspected heart attack 2 sprays (sublingually) may be repeated |
An adult patient begins complaining of sudden chest pain and a tingling sensation down their arm while in the dental chair, they appear pale and begin to sweat. What would your immediate response be? | call 999, state “heart attack” get the patient in a comfortable position give GTN spray (1-2 sprays sublingually) give patient aspirin to chew (be ready to give BLS if condition worsens) |
When might aspirin need to be used in the dental practise? (explain dosage) | suspected heart attack - 300mg oral chewed |
A patient suddenly collapses in the surgery and loses consciousness, they begin jerking and breathing noisily as well as frothing at the mouth. What is happening? What is your immediate response? | Epileptic Seizure get patient in a safe environment, remove anything from mouth and do not restrain administer oxygen 15L/min note timings of seizure call 999 if necessary if seizure is prolonged (>5mins) give midazolam oromucosal solution |
Why might midazolam oromucosal solution be used in the dental practise? What dosage would be used? | Prolonged convulsive seizures (> 5 mins) or repeated seizures (> 3 in one hour) - buccal route as a single dose of 10mg |
Why might glucose be used in the dental practise? What dosage would be given? | Patient suffering from a hypoglycaemic attack (able to swallow & co-operative) - 15-20g quick acting glucose |
Why might glucagon be used in the dental practise? What dosage would be given? | Patient is suffering from a hypoglycaemic attack (unable to swallow safely e.g unconscious) - 1mg IM |
what aspects should be covered when taking a patients medical history? | cardiovascular respiratory endocrine gastrointestinal blood disorders seizures/fits/headaches mucoskeletal THEN MEDICATIONS AT END & ALLERGY |
how would you assess a patients cardiovascular health? | do you have any heart conditions such as angina/heart attack/heart failure? any blood pressure problems? history of a stroke or clot? |
how would you assess a patients respiratory health? | do they have any breathing problems such as asthma/COPD - do they ever use inhaler |
how would you assess a patients gastrointestinal health? | do they have any gut problems such as Crohn’s/Ulcerative colitis do they have any reflux or stomach problems any liver problems? |
how would you assess a patient neurological health? | do you have history of fits/seizures/faints - any headache history |
how would you assess a patients endocrinological health? | any history of diabetes - any history of thyroid dysfunction |
how would you assess a patients mucoskeletal health? | do you have any history of arthritis or joint problems? - any bone disorders? |
how would you assess if a patient has any blood disorders? | do you experience prolonged bleeding after a cut? any blood disorders such as haemophilia? any transmitted blood disorders eg HIV/Hepatitis? |
how do you know if a patients allergy to something is mild or severe? | ask if they have had any hospital admissions related to the allergy |
If you suspect a patient is going through/went through a traumatic health disorder, how would you raise your concern in a polite way? | Ask if they had any previous hospital admissions/seen any specialists for a problem |
How does aspirin work to help a patient suffering from a suspected heart attack? | Inhibits platelet aggregation - thins the blood making it less likely to clot |
How does GTN spray work to help a patient suffering acute anginal distress? | Dilates veins which reduces preload to heart - Dilates colateral coronary artery supply (reduce anginal pain) |