National Dental Advisory Committee - Emergency Drugs & Equipment in Primary Dental Care

Background

The National Dental Advisory Committee (NDAC) publication Emergency Dental Drugs (NHS MEL (1999)) 22 identified a list of drugs and equipment which should be available to manage medical emergencies within the dental setting. It also highlighted the need for dentists to carry a full emergency drugs kit (including portable oxygen supply and suction) for all domiciliary visits.

Since 1999 a number of additional relevant documents have been published as follows:

• A Conscious Decision^[1] (2000). This resulted in the cessation of dental treatment under general anaesthesia in UK primary care settings.
• In 2006 the Resuscitation Council (UK) published standards for dental professionals in managing emergencies and resuscitation. In 2012 the Resuscitation Council revised these standards. The revised standards recommended the emergency drugs for use within a dental setting. In addition, the Council advised that Automatic External Defibrillators (AEDs) should be available in every healthcare environment.^[2]
• The Scottish Dental Clinical Effectiveness Programme published Drug Prescribing for Dentistry^[3] (2011). This included a list of drugs for use in medical emergencies together with information about their administration. This list reflected the list of emergency drugs recommended in British National Formulary (BNF)^[4] and in the updated guidance from the Resuscitation Council (2012).
• The Scottish Dental Clinical Effectiveness Programme published a Practice Support Manual^[5] with comprehensive lists of emergency drugs and equipment.
• A new Combined Practice Inspection document^[6] was introduced from in 2013 for all dental practices across Scotland. This was revised from 1 January 2015.
• In 2013 the Resuscitation Council published Quality standards for cardiopulmonary resuscitation practice and training. Primary dental care.^[7] These standards superseded those published in 2006 and do not cover aspects of managing medical emergencies beyond cardiopulmonary resuscitation. Information on medical emergencies encountered in dental practice other than cardiorespiratory arrest is now in the Prescribing in Dental Practice section of the British National Formulary (BNF)

A recent survey of Scottish Dental Practice Advisors reported that the provision of AEDs was not comprehensive or consistent either within or across Health Board areas.^[8]

In light of the recent changes in practice and guidance, the NDAC commissioned a short life working group to update the 1999 publication Emergency Dental Drugs.