Preparedness of dental clinics for medical emergencies in Riyadh, Saudi Arabia

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.

Evaluation of medical equipment maintenance and skilled manpower requirement among private dental centres in Riyadh, Saudi Arabia: A pilot study

BACKGROUND

Adequate equipment maintenance is necessary to ensure efficient dental care facilities and satisfactory medical equipment performance.

OBJECTIVE

This study aimed to assess maintenance practices and manpower adequacy in private dental centres (DCs) across Riyadh, Saudi Arabia.

METHODS

A questionnaire was designed to evaluate equipment maintenance and manpower strength based on international and national standards. Thirty-three private DCs were visited in-person with the designed questionnaire to conduct the study. The Chi-square test and t-test were performed.

RESULTS

Only 21 dental centres had a scheduled maintenance plan for medical equipment, whereas the rest had no plan. Furthermore, only 22 DCs maintained equipment maintenance records, while 11 DCs did not have any records. Additionally, the study found a lack of trained personnel to handle medical equipment and overall inadequate maintenance practices. Significant differences were observed between the responses for many questions (p< 0.05).

CONCLUSION

These findings increase health risks to both the patient and the user. To address these issues, DC administrators should implement stricter measures to adhere to local DCs standards and hire qualified personnel who can periodically maintain and repair medical equipment.

A Pilot Study of Preparedness of Dentists in the United Arab Emirates to Deal with Medical Emergencies

OBJECTIVES

 The purpose of this pilot study is to assess the United Arab Emirates dentists' preparedness to manage medical emergencies.

MATERIALS AND METHODS

 Ninety-seven licensed dentists participated in this study. Dentists responded to self-administrated questionnaires that contained 23 questions divided into five parts. The first part collected data on participants' sex, years of experience, and whether they are general dental practitioner (GDP) or specialists. The second part included seven questions that asked participants to indicate if they took medical history, obtained vital signs, and attended basic life support courses. The third part included six multiple choice questions regarding the availability of emergency drugs in the dental clinic. The fourth part consisted of three multiple-choice questions that assessed the dentists' immediate response to a medical emergency. Finally, the fifth part comprised four questions to evaluate the dentists' knowledge of proper treatment of special emergency cases they may encounter in the dental offices.

RESULTS

 Out of the 97 participants, only 51% (N = 49) indicated that they can handle emergencies such as anaphylactic shock and syncope in the dental office. The majority of the dentists (80%) indicated that they have emergency kits. Only 46% of the specialists and 42% of the GDPs were able to correctly plan extractions in a patient with a prosthetic heart valve. Less than half of the participants (N = 35, 36%) were able to correctly answer the question regarding management of a foreign-body aspiration by attempting Heimlich/Triple maneuver.

CONCLUSIONS

 Within the limitations of this study, dentists need further hands-on training to improve their skills and knowledge about medical emergencies that could occur in the dental settings. Furthermore, we recommend that guidelines should be available in the clinic to strengthen the dentists' ability to deal with medical emergencies.

Are dental professionals ready to deal with medical emergencies in their clinical office? A survey of university hospitals

This research aimed to assess the availability and need of dental emergency kits in Saudi Arabia university hospitals. A cross-sectional study was conducted among 267 dentists, including undergraduate, dental interns, general dentists, and specialists in 6 university hospitals (private and government colleges). In addition, a closed-ended questionnaire was distributed through emails using the online platform. The data revealed that 49.4% of dentists faced medical emergencies. Out of them, 72.7% said that emergency kits were available in their clinics. Sugar sources and oxygen were most commonly available. On the other hand, 37.8% of dentists handled emergencies independently, 34.5% considered themselves competent with cardiopulmonary resuscitation (CPR), and 28.8% were confident of using emergency (ER) drugs. The most common medical emergencies were vasovagal syncope and hypoglycemia. The emergency kit in dental clinics is relatively available, and the incidence of medical emergencies is relatively minor. However, the competence and confidence of the dentists in tackling an emergency is low, including handling of emergency (ER), knowledge of CPR, and its performance. Therefore, CPR courses should be improved and promoted more widely for this purpose.

Preparedness of Dentists and Dental Clinics for Medical Emergencies in Jordan

BACKGROUND

Dentistry, as most clinical specialties, has a wide range of invasive procedures in which patients are at risk of having a medical emergency (ME). The stress induced at clinic during treatment, the medically compromised elderly patients whom are increasing in number due to the new advancements in medicine and the invasive techniques such as injections, surgical flaps, devitalization or extractions are risk factors for medical emergencies' occurrence.

OBJECTIVE

The aim of this study was to assess the knowledge and the training of dentists and the availability of the emergency drugs and equipment in a sample of dental clinics in Jordan.

METHODS

A questionnaire was designed and distributed using an online service to dentists all over Jordan. It included different question categories; Demographic, Medical emergencies, emergency equipment and medications and dentists' self confidence and training to manage medical emergencies.

RESULTS

Number of 180 completed questionnaires were accepted for the study, 102 were females and 92 were specialists. 158 (87.8%) responders faced a medical emergency at their work place. Most common medical emergency faced in the clinic was the vasovagal attack 81(45%). Major emergencies were witnessed by 79(43.9%) of the dentists. 110 (61.1%) of the responding dentists had their training in medical emergency management after graduation from dental school while 49(27.7%) had their training during dental school. 156(86.7%) found themselves still in need for further training. Blood pressure meter was the most available device at clinics 33(18.3%) and was the most used. Defibrillators were only used by 13(11.3%) of the responders. Epinephrine, steroids and nitro-glycerine were the available drugs for medical emergencies management in the practices (27.8%, 26.7% and 18.9%) respectively. Most dentists were not confident enough to handle medical emergencies.

CONCLUSION

Preparedness of dentists and dental clinics to handle and manage medical emergencies needs further attention and focus to assure prevention and management of such incidents.

Design of Optimal Scheduling Model for Emergency Medical Supplies by Blockchain Technology

The study aims to explore the scheduling plan for the emergency of blockchain technology in the medical industry. Network security architecture for medical supplies management based on the Hyperledger Fabric optimized consensus mechanism is established by studying the characteristics of blockchain technology and its data structure composition. The supply chain model for medical device scheduling based on intelligent contracts is selected for the particularity of the nature and shape of medical devices in medical supplies. Ant colony algorithm is used to solve it. Case analysis and verification results show that the improved Hyperledger Fabric consensus mechanism has better security performance. Under the condition of 10,000 transactions, the probability of an attacker with the optimized consensus mechanism successfully controlling the transaction is only 7.2%. The optimized solution is about 50% higher than the original solution in terms of transaction processing speed. Over 1000 transactions, the transaction latency optimization rate is more than doubled. The total order completion time of the medical device scheduling model adopted by the intelligent contract is 26.3% higher than the historical service time of 19 days. The performance of the medical emergency material scheduling program that is added to the supply chain technology is better.

Perspectives of Dental Practitioners Regarding Their Readiness for Medical Emergencies: A Study in Saudi Arabia

Background:

Training dental practitioners on emergency preparedness and response is essential for the successful management of medical emergencies.

Objectives:

To assess the perceptions of dental practitioners in Saudi Arabia about their readiness to manage medical emergencies in the dental practices.

Methods:

This cross-sectional survey was conducted among dental practitioners working in 52 dental centers in Saudi Arabia. Questionnaires mainly gathered data on the measures taken by dental practitioners to prevent medical emergencies, BLS certification, availability of essential drugs and equipment, and perceptions of dental practitioners regarding the adequacy of their training for medical emergencies.

Results:

Of the total 270 participants, the majority reported that they take medical history (94%), perform visual inspection (90%), consult with patients’ physician when needed (89%), and modify treatment plan as necessary (94%). However, only 19% of them routinely take baseline vital signs for their patients and 52.6% have valid BLS certification. Only 29.6% and 16.3% of dental practitioners have reported that they have all essential drugs and equipment, respectively.

Conclusion:

The preventive measures for medical emergency appears to be deficient because most dental practitioners are not routinely taking baseline vital signs for their patients. This important issue is combined with shortage of BLS certification among dental practitioners and inadequate availability of all medical emergency drugs and equipment in dental practices.

A preparedness model for the provision of oral health care during unfolding threats: the case of the covid-19 pandemic

BACKGROUND

The aim of this study was to appraise a recently developed preparedness model for the provision of oral health care during a threat such as the COVID-19 pandemic from the perspectives of oral health care providers, administrators/staff, and patients.

METHODS

An exploratory qualitative inquiry via at-a-distance semi-structured interviews and group discussions engaged a purposefully selected sample of oral health care workers and patients in British Columbia (BC), Canada. Participants were asked to appraise a preparedness model by considering how to prepare for oral care during a pandemic, while answering open-ended questions about the model content and visual presentation. Interviews and group discussions occurred between April 2020 and January 2021, were audio recorded, and transcribed verbatim. An inductive coding process was used to identify themes, subthemes, and categories of information until saturation was achieved.

RESULTS

Seventy-four participants, including 19 dentists, 15 dental hygienists, 10 certified dental assistants, 9 administrators, and 21 patients, suggested modifications to the recently developed preparedness model. Individual interviews (41 participants) and group discussions (33 participants in groups ranging from 2 to 9 attendees each) lasted for an average of 53 min. Eighty-four hours of audio recordings led to more than 1110 single-spaced pages of transcripts. The thematic analysis identified 82 codes, 12 categories, and four main themes: life-long learning, critical thinking, personal and professional risk, and patient-centred care. These themes were understood within provider characteristics and social and environmental contexts. Participants highlighted the need for the model to focus on information and communication, developing awareness and understanding, inferring risks, and performing oral health care during a threat such as a pandemic or disease outbreak. A modified portrayal of the model was suggested to better represent participants' perspectives.

CONCLUSION

A recently developed preparedness model for the provision of dental care during an unfolding threat like the COVID-19 pandemic was appraised and modified by oral health care workers. Future studies are warranted to evaluate the modified model for use in the event of another unfolding threat collaboratively with providers, patients and stakeholders.

Psychometric Analysis of the European Medical Risk-Related History Questionnaire within Indonesian-Speaking Population

OBJECTIVES

Medical complications during dental treatment are increasingly anticipated because advances in medical treatment have prolonged life expectancy. Therefore, a thorough analysis of medical history data to assess the medical risks that may occur before, during, and after dental procedures is required. The European Medical Risk-Related History (EMRRH) questionnaire has been used in 10 European countries to detect medical problems and determine the risks of complications. However, no similar questionnaire has been developed for Indonesian patients. This study aimed to develop an Indonesian version of the EMRRH questionnaire and analyze its psychometric properties.

MATERIALS AND METHODS

The EMRRH questionnaire was utilized and processed for cross-cultural adaptation according to the Beaton guidelines. The final version was used after completing all of the steps of cross-cultural adaptation. The psychometric property analysis was performed by measuring the validity, reliability, sensitivity, and specificity of the questionnaire in 172 dental patients using cross-sectional survey at the National Drug Rehabilitation Center.

RESULTS

The content validity was first measured by an internist and anesthesiologist, and the coefficient was 0.91. The construct validity assessment revealed significant associations for five of six global questions (P < 0.05). Cronbach's alpha coefficient for internal consistency was 0.790. The test-retest reliability results were excellent based on reevaluation in 17 patients (intraclass correlation coefficient = 0.846), including sensitivity and specificity values of 69.31% and 92.2%, respectively.

CONCLUSION

The Indonesian version of the EMRRH questionnaire is valid, reliable, sensitive, and specific for this population. Further study to explore its use in larger Indonesian populations is needed.