Each month, Dental Nurse Network will take a look at issues that occur in practice and that affect us as dental nurses and as dental teams. If you have any thoughts on topics you would like us to look at, please email us at This email address is being protected from spambots. You need JavaScript enabled to view it..
This first month, we will be taking a look at medical emergencies. We have interviewed different members of the dental team to see how they have handled situations and what advice they would pass on to others facing such situations.
Spotlight on ... medical emergencies
A medical emergency can occur at any time in our practices and with any person – a patient, a patient’s carer, friend or family member, or a staff member. For those members of the team who are GDC-registered, it is a requirement of our registration that we know how to handle medical emergencies. For those who are not GDC-registered, there is still a role to play in ensuring the management of medical emergencies is smooth and effective and achieves the best outcome for everyone involved. As such, we should all be undertaking training at least annually as a team on how we would handle medical emergencies, and we should ensure that each member of the team knows what their role would be and what they should do.
After all our training, how do we actually handle situations in reality? Does our training kick in, and do we all act as we have planned? How do we feel afterwards?
To find answers to these questions, we asked several members of the dental team about a situation they have faced in practice.
Team Member 1
How long have you worked in dentistry?
Four months, part time.
What is your role in the dental practice?
Receptionist.
How often does your practice carry out medical emergency training?
Once a year we do CPR training, and once a year we look at the emergency drugs and kit we have in practice and how we use them. These are usually covered in separate sessions.
Can you describe a situation you have dealt with/been involved in the management of?
A patient had an extraction, but a few minutes after he left the practice he came back with excessive bleeding from his nose. There was a lot of blood!
How did the team respond to the situation and what did you do?
The patient was taken back into the surgery, and the dentists and nurses tried to stop the bleeding. I informed the patients who were waiting that there would be a delay, as the dentists were dealing with a patient who was not feeling well. Then I cleared up the reception and waiting room floor areas. After about five minutes, our reception manager was asked to call an ambulance because the bleeding was not stopping.
How did you feel after the situation?
I was quite shaky, as I had never had to deal with a situation like that before. I made a mistake in that I went to clean up the blood without gloves or a mask on, but my manager stopped me and reminded me to put them on before I started; I think it was being nervous that made me forget.
Overall, though, I think the whole team handled the situation very professionally. Outwardly, everyone seemed very calm, although afterwards we discussed it as a team and everyone said that they had been very shocked. The dentists both said they had never had a situation like it. One of the dentists said they had been very worried, as bleeding like that was something we have very little ability to handle in practice. Other than applying pressure to the bridge of the nose, we could not do anything other than dial 999.
I feel it was good for me to see how well the team work together.
What is one piece of advice you would give to someone facing a similar situation?
The main thing is to stay calm and ensure that everyone knows what everyone else is doing. For example, we know that if an ambulance is needed, the reception manager calls them, which means that we are not all running for the telephone at once.
Team Member 2
How long have you worked in dentistry?
Three years.
What is your role in the dental practice?
I am a dental nurse – I qualified last year.
How often does your practice carry out medical emergency training?
Once a year we do team training, including emergency drugs, CPR and defibrillator.
Can you describe a situation you have dealt with/been involved in the management of?
Luckily, I have not had any real emergency situations so far. We did have a nervous patient who felt faint after treatment.
How did the team respond to the situation and what did you do?
I noticed the patient was looking a bit wobbly as they were putting their coat on and asked if they were feeling ok. They sort of just looked at me and the dentist then looked up from writing their notes, saw that the patient was looking pale, and immediately asked the patient to sit back down in the dental chair. We then tilted the chair back so that the patient’s feet were slightly higher than their head. After a few minutes, the patient began to feel better, so the dentist slowly sat them back up. We then gave them a dextrose tablet and some water. We checked they were feeling ok to leave before escorting them to reception. At the end of the day, I phoned the patient to check everything had been ok after they left.
How did you feel after the situation?
I was happy that we handled the situation well and I didn't feel panicked.
What is one piece of advice you would give to someone facing a similar situation?
I would say to ensure you pay close attention to nervous patients after any treatment, as they are more likely to feel unwell.
Team Member 3
How long have you worked in dentistry?
Seventeen years.
What is your role in the dental practice?
Locum dental nurse.
How often does your practice carry out medical emergency training?
I work with several different practices and I ensure I do medical emergency training and CPR training at least once a year, but sometimes I do this more often if asked to join in by a practice.
Can you describe a situation you have dealt with/been involved in the management of?
The only real (touch wood) medical emergency situation I have been involved with actually took place outside of a dental practice. A friend of mine, who was not diagnosed as having epilepsy, was not feeling well one evening whilst I was visiting and suddenly started to have a seizure. As she fell down, she hit her head badly on the corner of a table.
How did the team respond to the situation and what did you do?
It was a really scary situation as I was the only person with any form of medical emergency training in the house. I ensured that everything was cleared out of the way, including moving the table further away. At the same time, I got her husband to call 999. As he was a bit panicked, I also told him to go and stand at the front door to wait for the ambulance – it was really unhelpful to have someone panicking and trying to hold her still. Once the seizure finished, I got a towel and held it to her head to try to slow the bleeding until the ambulance arrived.
How did you feel after the situation?
I felt really numb just after the ambulance had left – and then I suddenly burst into tears! It was really upsetting to see a friend in that situation, although I do think that having completed medical emergency training helped in that I kept calm and knew not to try to restrict my friend’s movements. It also was important to try to manage the whole scene by making sure her husband was kept calm too.
What is one piece of advice you would give to someone facing a similar situation?
Make sure you do training, not just in CPR but in medical emergencies and that you are aware you may have to handle situations at any time – not just in practice where you have other trained people.