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

Training in the management of medical emergencies

The 1999 NDAC Emergency Dental Drugs document recommended that all dental professionals in contact with patients should receive annual training in Emergency Life Support (ELS), and that the training should be undertaken by an accredited instructor. Within Scotland resuscitation training is a practice inspection requirement. The General Dental Council highly recommends that dental registrants undertake resuscitation training as part of their Continuing Professional Development.^[9]

Training in cardiopulmonary resuscitation within the dental setting should follow Resuscitation Council guidance^[7]. The management of other medical emergencies should also be covered in the training session. It is important that both dental professionals and the public are reassured that the training they undertake is of a consistently high standard across all parts of Scotland. It is therefore recommended that records of staff medical emergency training are made available at practice inspection. The contents of the training should follow Resuscitation Council (UK) standards, advice in the BNF and General Dental Council (GDC) guidance.

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 is likely to encounter in dental practice. These will include cardiac arrest, myocardial infarction, anaphylactic reactions, vasovagal attacks, seizures, and hypoglycaemia. A course manual should be distributed prior to the training session.

The content of any training should include:

1. Assessment of the patient using the ABCDE rapid assessment tool.

2. Basic Life Support (BLS) sequence (adult and child), including risks to the rescuer and victim, rescue breaths, chest compression, regurgitation during CPR, choking and the recovery position.

3. Use of oxygen, oro-pharyngeal airways and bag-valve-mask ventilation.

4. Use of emergency drugs to manage dental emergencies. This should include a practical demonstration of each item within the emergency drug kit.

5. Practical demonstration and training in the use of an automatic external defibrillator.

Resuscitation training for the dental team can be undertaken within the practice or at local or regional training centres. Qualified trainers in resuscitation from within the dental practice staff should be encouraged to deliver 'cascade' training to other staff members (e.g. in BLS).

NHS Board Public Dental Services may require some of their employed clinical staff to undertake training in more advanced techniques such as Immediate Life Support (ILS) which will require a trainer of more advanced skills (e.g. Resuscitation Officer) or attendance at a designated course. Also, this may be an appropriate level of training for practices delivering treatment under sedation. Detailed training options for dental professionals can be found in Resuscitation Council guidance.

All training should be logged and records of staff medical emergency training must be available at the Practice Inspection visit.