Medical emergencies in dental practice: A nationwide web-based survey of Italian dentists

Lebanese Dentists' Preparedness to Deal With Medical Emergencies in Their Clinics: A National Survey

INTRODUCTION AND AIMS

Health-related emergencies, from minor incidents to life-threatening situations, can occur unexpectedly in dental clinics. Ensuring that dentists and their teams are well-prepared with adequate training and essential equipment is crucial. Proper preparedness can lead to effective management of emergencies and reduce potential complications. This cross-sectional national study aimed at assessing the preparedness of Lebanese dentists in managing medical emergencies.

METHODS

Data was collected between August and October 2024 using an online questionnaire which was distributed to all registered Lebanese dentists through the Lebanese Dental Associations located in Beirut and Tripoli.

RESULTS

The study found that 38.2% of dentists had an emergency kit in their clinics, and 88.0% had some emergency equipment; yet only 5.9% had a defibrillator. While 71.3% had emergency training in university, 28.5% never received it. Only 18.8% reported staff training in medical emergencies. Most dentists (74.2%) encountered minor medical issues, and 22.4% faced major emergencies, with only 1.8% reporting cardiac arrest cases. Vasovagal reactions, hypoglycemia, and orthostatic hypotension were common emergencies. While 69.0% felt capable of managing minor issues, confidence dropped for major emergencies and specific procedures. An overwhelming 87.8% expressed a need for more emergency training. Post-graduation training, prior defibrillator use, and having an emergency kit were linked to better emergency management capabilities in the logistic regressions.

CONCLUSION

The findings of this study indicate significant gaps in emergency preparedness among Lebanese dentists. Many lack adequate training and resources, highlighting the urgent need for further training and better-equipped clinics. Strengthening policy frameworks and resource allocation is crucial.

CLINICAL RELEVANCE

Stakeholders should prioritize implementing mandatory training programs and developing clear guidelines to ensure that dental clinics in Lebanon are adequately prepared to manage health-related emergencies effectively.

[Analysis of death cases in the oral emergency department]

In order to analyze the clinical characteristics of death cases in the oral emergency department of the stomatological hospital, and to improve the first aid technique before and in hospitals, we collected the clinical data of death cases in the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2010 to January 2023 for retrospective analysis. General cha-racteristics, such as the patients' gender, age, chief complaint, maxillofacial diseases, systemic underlying diseases, rescue situation, cause of death and seasonal distribution of death were summarized. The results showed that a total of 8 death cases (5 males and 3 females) occurred during the 13-year period, ranging in age from 40 to 86 years, with a median age of 66 years. Among the 8 patients, 5 reported bleeding from oral cancer, 1 reported chest tightness and dyspnea after oral cancer surgery, 1 reported loss of consciousness after maxillofacial trauma, and 1 reported oral erosion and aphagia. All the 8 patients had one or more underlying diseases, such as hypertension, coronary heart disease, diabetes, renal failure, and cerebral infarction, etc. and 2 of them showed dyscrasia. Among them, the cause of death in 5 cases was respiratory and circulatory failure caused by oral cancer rupture and hemorrhage or poor surgical wound healing and hemorrhage; 1 case was uremia and hyperkalemia leading to circulatory failure; 1 case was asphyxia caused by swelling of oral floor tissue after maxillofacial trauma; and the other case was acute myocardial infarction caused circulatory failure after oral cancer surgery. According to the vital state at the time of treatment, 6 patients had loss of consciousness, respiratory and cardiac arrest before hospital, and 2 patients suffered from loss of consciousness, respiratory and cardiac arrest during treatment. All the patients received cardiopulmonary resuscitation and some advanced life support measures, and the average rescue time was 46 min. Due to the low incidence of death in the oral emergency department, medical personel have little experience in first aid. First aid training and drills and assessment should be organized regularly. First aid facilities should be always available and regularly maintained by special personnel, such as electrocardiogram (ECG) monitor, defibrillator, simple breathing apparatus, oxygen supply system, negative pressure suction system, endotracheal intubation and tracheotomy equipment. The death cases mainly occurred in the elderly patients with oral cancer bleeding and systemic underlying diseases. Education of emergency awareness for the elderly patients with oral cancer after surgery should be enhanced. Medical staff should strengthen first aid awareness and skills.