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Medical Emergancies

By 26 February, 2020Members, Uncategorized

We all hope that we never have to deal with medical emergencies.  I’ve been lucky in that regard throughout my career.  I’ve had a few “oh shit” moments, but never one of the big ones.  From memory, I’ve had to call an ambulance three times in 22 years of practice.

The main things we saw were faints.  Those are fairly easy to deal with.

A lot of this will be down to luck and the will of Odin, but I would also like to think that the systems I implemented helped head off some of the worst of it.  These systems included

  • Updating the medical history at ever oral health review.  Whilst we got them to sign a form, we asked them the specific questions.  This helped avoid, for example, the patient you have just numbed up for an extraction asking if it matters that they had a heart attack 3 weeks before.
  • Taking blood pressure of all patients we did any kind of surgery on.
  • Listening to the voice in the back of your head that tells you to avoid doing something like the plague
  • Getting to know the patients so they can be honest with you and not fear that their concerns will be dismissed or that they will be judged.
  • Giving pre and post-operative instructions that you actually go through with whilst the patient is there…before you numb them up.
  • Making sure the patient has eaten before any procedure (difficult with some religious fasting I know, but we managed)
  • Ringing the patient up at home after anything “nasty”.  You don’t need me to tell you what that means
  • Finding alternatives to ID blocks (patients loved us for it)
  • Being ready for if the shit hit the fan.  For example, having the drugs split into separate boxes based on the medical emergency instead of having them all rammed in together.

The last one is vital because, despite your best efforts, the unexpected will happen.  Now I’ve always thought that the “once a year” training was inadequate.  To be able to deal with a medical emergency takes practice.  Repetition is the mother of skill.

Remember the first time you tried to do a root filling? You were likely nervous, hesitant, worried about what you were doing.  The damn dam wouldn’t go on, and you couldn;t even find the canal.  Perhaps you were fortunate, or perhaps you were faffing around for half an hour before you even started.

So how would that translate to a medical emergency?

One of the best things you can do it get your team booked on one of the simulation suites across the country.  There’s one in Nottingham and Leeds for example.  It’s a mannequin that communicates with you whilst it goes through its medical emergency scenario.

You also need the proper kit and ensure it is in date and in good order.  It needs to be easily accessible, and everyone needs to know where it is.  Everyone needs to know what’s in it and how to use it.  Even with the CQC poking their noses into every crevice, some practices still aren’t up to scratch on this.

In my opinion, you also need to systemise the approach to such unwanted events.  Everyone needs to know their part, and it’s good to have printouts with the various aspect of your emergency kit so that anyone can refer to them to tell them what is used for when. When things go south, you can sometimes freeze, your mind can go blank and that isn’t very good for anyone involved.

Systems let you flow through your diagnosis into treatment.  It’s what I created for my practice, and thankfully I rarely had to use it. The system I created is now available on my website for purchase, link is at the bottom if you are interested.  Do know however this isn’t a one size fits all approach.  There is a reason it comes as a WORD document rather than a PDF.  The system has to be based on present guidance, and that guidance changes yearly.  So anything put together might be obsolete tomorrow.  Also, the recommendations vary depending on what part of the country you are in.

So this product is generic in nature.  To use this in your practice, you can’t just print it off and bung it in the cupboard.  You need to:

  • Check each and every aspect is correct for your part of the country
  • Check that the system works for your practice.  it may need alteration
  • Check it regularly to keep it up to date
  • Take ownership of the system, because you will be the one using it.  Remember, I’m just some bloke on the internet… what if I made an error in there?

So if you want something that involves no effort on your part, this definitely isn’t for you.  It’s a starting point to save you time and can also be a good reference point for where you are presently at with your emergency preperations.

Medical Emergency System