Emergency drugs and equipment in primary dental care

6 Training in the management of medical emergencies

The General Dental Council (GDC) ‘Scope of Practice’ states “A patient could collapse on any premises at any time, whether they have received treatment or not. It is therefore essential that ALL registrants are trained in dealing with medical emergencies, including resuscitation, and possess up to date evidence of capability”.^[13] Continuing Professional Development (CPD) in medical emergencies is highly recommended by the GDC, with at least 10 hours in each CPD cycle, and at least two hours of this type of activity every year.^[14] If a registrant’s work role or setting changes, their role in the event of a medical emergency might also change and they should ensure that they are sufficiently trained and competent to carry out that role.

The GDC also advises that registrants must follow the guidance on medical emergencies and training updates from the Resuscitation Council UK.^[15] Training requirements for cardiopulmonary resuscitation (CPR) in a dental setting are outlined in the Resuscitation Council UK’s ‘Quality Standards: Primary dental care’.^[16] This includes new members of dental staff undertaking resuscitation training as part of their induction, and all dental staff updating their knowledge and resuscitation skills at least annually.

The management of other medical emergencies should also be covered in the training. Information on medical emergencies encountered in a dental practice, other than cardiorespiratory arrest, is provided by the British National Formulary (BNF).^[1]

Training should use scenarios to allow the dental team to practise the assessment and management of patients with the life-threatening conditions that a dental professional might encounter in dental practice. These include cardiac emergencies, anaphylactic reactions, syncope, seizures, and hypoglycaemia.

The content of any training should include:

• Assessment of the patient using the ABCDE rapid assessment approach.
• Basic Life Support (BLS) sequence (for adults^[17] and children^[18]), including management of choking and the recovery position.
• Manual airway opening manoeuvers, use of oxygen, oro-pharyngeal airways and bag-valve-mask ventilation.
• Use of emergency drugs to manage dental emergencies.
• Practical demonstration and training in the use of an Automated External Defibrillator.

Resuscitation training for the dental team can be undertaken within the practice or at local or regional training centres.^[16] Course information, including learning objectives, should be provided before the training session.

All training should be logged.^[16] Within Scotland, staff training records for medical emergencies, including CPR, must be available for the Combined Practice Inspection.^[19]