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SIG-Management of Medical Emergencies

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Special Interest Group - Management of Medical Conditions & Medical Emergencies in Dental Practice

"When you prepare for emergencies, they cease to exist" - Malamed

The incidence of medical problems in the general population is on the rise due to various factors. Consequently the number of medically compromised patients presenting for dental treatment is also on the rise. In order to provide dental treatment safely to these medically compromised patients, a proper understanding of their medical conditions, medications taken & investigations required is very essential. Medical emergency in a susceptible person can present anytime including during dental treatment. The nature of treatment rendered & medications used in dentistry could also precipitate medical emergencies in such patients. The appropriate management of such an emergency will require proper knowledge & training before hand. These skills will require frequent reinforcement to maintain a high level of preparedness.

Good dental practice requires that a dental practitioner be aware of those medical conditions that might present first with oral manifestations and those for which special considerations are required before dental treatment is rendered. In view of the rapid changes in the understanding and treatment of disease, it is essential that a dentist be current in his knowledge of medicine and be aware of the established and accepted methods of patient management. The ultimate goal in the management of all emergencies is the preservation of life. The prime requisite in managing an emergency is maintenance of proper Position (P), Airway (A), Breathing (B), Circulation (C), and Definitive treatment (D).

The Special Interest Group (SIG) for medical problems & medical emergencies in dentistry aspires to bring together clinicians from JSS AHER who wish to participate in education & research to format Standard Operating Procedure (SOP) in these conditions which should benefit patients, clinicians & trainees.

Some of the medical conditions which can cause problems to the oral health are:

  • Diabetes
  • HIV/AIDS
  • Temporomandibular Disorders (TMD)
  • Malignancies
  • Thyroid disorders
  • Anaphylaxis
  • Airway Obstruction
  • Syncope & Chest pain
  • Local Anesthetic toxicity
  • Asthmatic attack & Seizures
  • Hemorrhage
Toothbook
Toothbook

Short Term Objectives

  • To provide a forum for discussion among the investigators, interested faculty & trainees on the topic of medical conditions & medical emergencies in dentistry
  • To conduct seminars addressing specific medical conditions & how they affect the provision of dental treatment to such patients.
  • To conduct hands on workshop to provide the knowledge & skills required for the management of medical emergencies like basic life support training on mannequin, IV cannulation on models, use of emergency drugs, etc.
  • To conduct research for evaluating the change in knowledge, confidence & skills of dental surgeons in the management of medical problems & emergencies in dental practice after undergoing the requisite training conducted by the SIG team.


Long Term Objectives

  • To formulate a Standard Operating Procedure (SOP) with regard to patient presenting with medical conditions & having a medical emergency during dental treatment at JSS AHER constituent colleges/centers.
  • To conduct research project for formulating protocols in patients taking anti-platelets agents undergoing minor oral surgical procedures in the institution.
  • To conduct research & educational programs on "Judicial use of Antibiotics in Dentistry".
  • To enable funding for a well-equipped skill station with the necessary equipment & materials to provide training in the management of medical emergencies presenting during dental treatment.

Goal

To prepare health professional faculty & students with the knowledge, skills and attitudes necessary for managing medical emergencies presenting during dental treatment.

"SIG TEAM MEMBERS"

Toothbook
Toothbook

"WORKSHOP ON MANAGEMENT OF MEDICALLY COMPROMISED PATIENTS AND HANDS-ON COURSE ON BASIC LIFE SUPPORT"

Toothbook

Release of BLS Manual

Toothbook

BLS Provider's Course - Student Dental Conference

Activities of SIG-Management of Medical Conditions & Medical Emergencies in Dental Practice

1. Workshop on management of medically compromised patients & Hands-on Course on BLS

The Special Interest Group “Management of Medical Problems and Medical Emergencies in Dentistry” of JSS Academy of Higher Education & Research conducted a two-day workshop on management of medically compromised patients in dentistry and hands-on course on Basic life support to 65 dental graduates and students on 7th and 8th February 2018. The Programme was inaugurated by Dr Manjunatha B, Registrar, JSS Academy of Higher Education and Research in the presence of Dr Ravindra, Principal and Dr Dakshaini MR Vice principal, JSS Dental College and Hospital. A brief introduction of the theme of the SIG was presented by Dr Shyam Sundar on behalf of the Special Interest Group.

Dr. Sahith Kumar Shetty (SIG group Co-ordinator) introduced the team members Dr Manjula S, Dr Shyam Sundar S, Dr Shivananda S, Dr Chandan S N, Dr Mahesh M, Dr Mamatha S and Dr Sheela Kumar Gujjari. A Booklet ‘Manual of Basic Life support’ was released by Dr Manjunatha B. He in his inaugural address congratulated the SIG team for this initiative and also suggested that BLS course be mandatory for under and post graduate students. Dr Ravindra,Prinicipal, JSS Dental College and Hospital, appreciated this idea and suggested that BLS course also needs to extended to police personnel also.Dr Shivananda S delivered the vote of thanks.

Day 2 started with a theoretical and practical demonstration of basic life support. The importance of survival chain and the use of AED (Automated External Defibrillator) in cardiac arrest patients was stressed. Single rescuer CPR and CPR with 2 rescue persons were demonstrated practically and with video sessions created and enacted by the SIG team with the support of Dr Harsha Raj & Dr Ganesh.This was followed by training sessions on mannequins. The post lunch session consisted of theory and Practical examination and the participants were evaluated based on their performance.The sessions were very interactive and participants commended the sessions on day 1 and hands-on course on day 2 with a positive feedback that they wanted more such courses conducted regularly.



2. Basic Life Support Provider's Course - Student Dental Conference

Basic Life Support (BLS) course offered by American Heart Association was provided to students during Student Dental Conference 2019, JSS Dental College & Hospital. The BLS guidelines were provided to the students one month prior to the course. The guidelines highlighted a set of clinical interventions for the immediate emergency management of cardiac arrest, heart attack and other life threatening medical emergencies as well as knowledge and skills to apply those interventions.

The guidelines were set into several groups of algorithms or instructions that are followed, and to increase its effectiveness. The major algorithm in the guidelines was the Cardiac Arrest Algorithm. During the course, the students got training in essential skills individually, as part of a team, and as team leader in different learning stations based on simulated clinical scenarios. The students learnt the basics of resuscitation like chest compressions, adult and infant breaths, management of choking in adults and infants etc. Realistic simulations were focused on the following key concepts: proficiency in recognizing and initiating early management of peri-arrest conditions, of chocking and the supportive care, identifying and treating, recognizing other life-threatening clinical situations such as cardiac arrest and providing initial care, applying BLS algorithms and effective resuscitation team dynamics.

At the end of the course, students appeared for a written test to evaluate the knowledge on clinical interventions for the emergency management of life threatening conditions. The students who passed the written test & successfully completed the course were provided with American Heart Association Basic Life Support certification card.

SIG Team Members

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Dr Sahith Kumar Shetty

Group Leader
Associate Professor

Dept. of Oral and Maxillofacial Surgery

JSS Dental College & Hospital, Mysuru
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Dr Manjula S

Member
Reader

Dept. of Oral and Maxillofacial Surgery

JSS Dental College & Hospital, Mysuru
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Dr Shivananda S

Member
Reader

Dept. of Oral and Maxillofacial Surgery

JSS Dental College & Hospital, Mysuru
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Dr Shyam Sundar S

Member
Reader

Dept. of Oral and Maxillofacial Surgery

JSS Dental College & Hospital, Mysuru
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Dr Chandan S N

Member
Reader

Dept. of Oral and Maxillofacial Surgery

JSS Dental College & Hospital, Mysuru
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Dr Mahesh M

Member
Professor

Unit Head, Dept. of General Medicine

JSS Medical College and Hospital, Mysuru
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Dr Mamatha S

Member
Associate Professor

Dept. of Obstetrics & Gynaecology

JSS Medical College and Hospital, Mysuru

Activities & Events

JSS Academy of Higher Education & Research