DH 112 - Medical Assessment/Emergencies

Credits: 2
Instructional Contact Hours: 3

Provides the opportunity to practice assessment, identification, and dental hygiene treatment protocol of septicemic emergencies which may occur in treating the dental patient.

Prerequisite(s): Validation for and successful clincal entry to the Dental Hygiene Program.

Corequisite(s): DH 110 , DH 111 , DH 114 , DH 115 , DH 116 , DH 118
Lecture Hours: 15 Lab Hours: 30
Meets MTA Requirement: None
Pass/NoCredit: No

Outcomes and Objectives

Identify the procedures associated with vital signs.
1. Describe each vital sign: pulse, respiration, temperature and blood pressure.
2. Identify the normal ranges for vital signs for adults and children.
3. Determine when it is appropriate to take vital signs.
4. Identify the appropriate equipment utilized for taking vital signs.
5. State the factors that influence pulse rate.
6. Describe the procedure for determining pulse rate.
7. Discuss pulse rate utilizing the terms bradycardia and tachycardia
8. Describe the technique to measure a patient's respiration.
9. State the factors that influence respiratory rate.
10. Discuss respirations utilizing the terms anoxia, and apnea.
11. Describe the advantages and disadvantage of the various types of blood pressure equipment.
12. Describe the technique to measure a patient’s blood pressure.
13. Identify factors that may increase or decrease blood pressure.
14. Analyze the differences and similarities of the terms auscultation and kortkoff sounds.
15. Analyze the differences and similarities of the terms diastole, diastolic pressure, systole, and systolic pressure.
16. Utilize normotensive and stethoscope while discussing blood pressure with a dental professional.
17. List two methods of taking a temperature.
18. Describe normal body temperature of children and adults and temperature variations.
19. Indicate factors that alter body temperature.
20. Analyze the differences and similarities of the terms pyrexia, hyperthermia and hypothermia related to temperature.
Provide an overview of what occurs in the body related to asthma, COPD, and hyperventilation.
1. Describe what occurs within the body when a patient is hyperventilating.
2. Describe what occurs within the body when a patient is experiencing an asthma attack.
3. Explain what occurs in the body when a patient has COPD.
Assess the respiratory patient.
1. Assess medical history for respiratory health problems.
2. Ask appropriate questions and document answers related to respiratory problems.
3. Identify contraindications for the patient with respiratory problems.
4. Describe how to alter the DH careplan for the respiratory patient.
Explain protocol for treating respiratory emergencies in dentistry.
1. Identify the signs and symptoms of the hyperventilation.
2. Identify first aid procedures for hyperventilation.
3. Follow the dental hygiene and college emergency protocol.
4. List the signs and symptoms of the asthma.
5. Identify first aid procedures for asthma.
6. Follow the dental hygiene and college emergency protocol.
7. Identify the signs and symptoms of COPD.
8. Identify first aid procedures for COPD.
9. Follow the dental hygiene and college emergency protocol.
10. Analyze the differences and similarities of the signs, symptoms and emergency treatment procedure for hyperventilation, asthma attack, and COPD.
Provide an overview of what occurs in the body related to syncope, a delayed allergic reaction, or anaphylaxis.
1. Describe what occurs within the body when a patient is experiencing syncope.
2. Describe what occurs within the body when a patient is experiencing a delayed allergic reaction.
3. Describe what occurs within the body when a patient is experiencing an anaphylactic reaction.
Assess the patient with a history of syncope or an allergy.
1. Assess medical history for syncope or allergy-related health problems.
2. Ask appropriate questions and documents answers related to syncope or allergy problems.
3. Identify contraindications for the patient with allergies or a history of syncope.
4. Describe how to alter the DH careplan for the patient with syncope or an allergy.
Explain protocol for treating for syncope or allergy-related emergencies in dentistry.
1. Recognize the signs and symptoms of the syncope.
2. Implement first aid procedures for syncope.
3. Recognize the signs and symptoms of the delayed allergic reaction.
4. Implement first aid procedures for delayed allergic reaction.
5. Recognize the signs and symptoms of the anaphylaxis.
6. Implement first aid procedures for anaphylaxis.
7. Follow the dental hygiene and college emergency protocol for syncope, delayed allergic reaction or anaphylaxis.
8. Analyze the differences and similarities of the signs, symptoms and emergency treatment procedure for syncope, delayed allergic reaction, and anaphylaxis.
Provide an overview of what occurs in the body related to diabetes.
1. Discuss the stable, unstable and brittle (labile)diabetic patient.
2. Analyze the differences and similarities of Type I and Type II diabetes.
3. Analyze the differences and similarities of Type I and II diabetes related to medications, diet, exercise and stress.
4. Identify the signs and symptoms of an undiagnosed diabetic.
5. Analyze the differences and similarities of the signs, symptoms, and emergency treatment of a diabetic in insulin shock (hypoglycemia) and diabetic coma (hypo- or hyperglycemia).
6. Analyze the differences and similarities of insulin and oral hypoglycemic agents.
7. Analyze the differences and similarities of blood glucose readings and A1c readings.
8. Identify possible long term health issues of a diabetic patient.
9. Analyze the differences and similarities of the terms hyperglycemia and hypoglycemia.
10. Indicate what may contribute to hyperglycemia and hypoglycemia.
11. Describe the difference between gestational diabetes and Type I or TypeII diabetes.
12. Explain the impact uncontrolled diabetes has on the periodontal condition.
13. Discuss how insulin assists with controlling glucose levels.
14. Describe the difference between diabetes insipidus and diabetes mellitus.
15. Analyze the differences and similarities of the modes of control for diabetes.
16. Describe what assessment(s) to utilize to determine if a patient maybe an undiagnosed diabetic.
17. Discuss why it is important to identify patients who might have diabetes.
18. Discuss the oral findings that may occur with the diabetic patient.
19. Identify possible treatment modifications for a diabetic patient.
Assess the diabetic patient.
1. Assess medical history for diabetic health problems.
2. Ask appropriate questions and document answers related to diabetes.
3. Identify contraindications for the diabetic patient.
4. Describe how to alter the DH care plan for the diabetic patient.
Explain protocol for treating diabetes related emergencies in dentistry.
1. Recognize the signs and symptoms of the hyperglycemia.
2. Implement first aid procedures for hyperglycemia.
3. Recognize the signs and symptoms of the hypoglycemia.
4. Implement first aid procedures for hypoglycemia.
5. Follow the dental hygiene and college emergency protocol.
6. Analyze the differences and similarities of the signs, symptoms and emergency treatment procedure for hyperglycemic and hypoglycemic emergencies.
Provide an overview of what occurs in the body related to neurological disorders.
1. Define epilepsy.
2. Describe the etiology of seizure/convulsive disorder.
3. Explain the seizure classifications: focal onset (partial), generalized onset and unknown onset.
4. Compare and contrast symptoms of a motor (tonic clonic) seizure and non-motor (absence) seizure.
5. Identify common drug(s) for the control of epilepsy.
6. Describe the most common oral manifestations as a result of taking antiepileptic drugs, such as phenytoin.
7. Describe the oral manifestations commonly seen with patients who experience tonic clonic seizure activity.
8. Describe an aura and determine when it will normally occur.
9. Analyze the differences and similarities of the tonic and clonic activity of a seizure.
10. Analyze the differences and similarities of what occurs during the pre-ictal, ictal and post ictal phase of a seizure.
11. Describe status epilepticus, the severity of the condition and the emergency steps to implement.
12. Describe how epilepsy may alter the dental careplan.
13. Define prodrome (prodromal signs) and identify when this may occur.
14. Analyze the differences and similarities of terms related to seizures.
15. Describe precipitating factors that may cause a seizure.
16. Describe emergency care during pre-ictal, ictal and post-ictal phase of the seizure.
17. Analyze the differences and similarities of a transient ischemic attack (TIA) and a cerebrovascular accident (CVA)
18. Identify permanent effects of a CVA.
19. Analyze the differences and similarities of an ischemic stroke and a hemorrhagic stroke.
Assess the neurological patient.
1. Assess medical history for neurological health problems.
2. Ask appropriate questions and documents answers related to neurological health problems.
3. Identify contraindications for the neurological patient.
4. Identify how to alter the DH care plan for the neurological patient.
Explain protocol for treating neurological emergencies in dentistry.
1. Recognize the signs and symptoms of the non-motor (absence) seizure.
2. Implement first aid procedures for non-motor (absence) seizure.
3. Recognize the signs and symptoms of the motor (tonic clonic) seizure.
4. Implement first aid procedures for motor (tonic clonic) seizure.
5. Recognize the signs and symptoms of the cerebral vascular accident.
6. Implement first aid procedures for cerebral vascular accident.
7. Follow the dental hygiene and college emergency protocol for seizures and CVA.
Provide an overview of what occurs in the body related to cardiovascular disorders.
1. Identify the etiology of heart disease.
2. Describe what is causing a heart attack and how the heart is affected.
3. Identify what medications maybe given for angina.
4. Describe the effect nitroglycerin has on the vascular system.
5. Describe what is occurring in the body that causes congestive heart failure.
6. Differentiate between left and right sided congestive heart failure.
7. Describe sudden death.
8. Compare and contrast heart attack, congestive heart failure and sudden death.
9. Analyze the differences and similarities of the etiology, signs, symptoms, contraindications, and treatment for hypertension and congestive heart failure.
10. Analyze the differences and similarities of the etiology, signs, symptoms, treatment, and contraindications for patients with a cardiac pacemaker and previous cardiovascular surgery.
11. Analyze the differences and similarities of atrial septal defect, patent ductus arteriosus and ventricular septal defect.
12. Analyze the differences and similarities of the etiology, signs, symptoms, and emergency treatment and contraindications for angina pectoris and myocardial infarction.
13. Describe why a patient may be on anticoagulant therapy.
14. Determine two types of patients that may need anticoagulant therapy.
15. Describe rheumatic heart disease, the etiology, and the affect it has on the heart.
16. Determine how rheumatic heart disease may be prevented.
17. Describe infective endocarditis, the etiology, and the affect it has on the heart.
Assess the cardiovascular patient.
1. Assess medical history for cardiac health problems.
2. Ask appropriate questions and document answers and documents answers related to cardiac problems.
3. Identify contraindications for the cardiac patient.
4. Describe how to alter the DH careplan for the cardiac patient.
Explain protocol for treating cardiac emergencies in dentistry.
1. Recognize the signs and symptoms of the angina.
2. Implement first aid procedures for angina.
3. Follow the dental hygiene and college emergency protocol.
4. Recognize the signs and symptoms of cardiac arrest.
5. Implement first aid procedures for cardiac arrest.
6. Follow the dental hygiene and college emergency protocol.
Assess the patient for conditions in which an antibiotic premedication may be prescribed.
1. Recognize conditions in which antibiotic premedication may be indicated.
2. Explain why antibiotic premedication is indicated for a patient with a prosthetic heart valve or repair.
3. Explain why antibiotic premedication is indicated for a patient with a heart replacement that exhibits abnormal function.
4. Describe how a heart valve repair or abnormal valve function may lead to infective endocarditis.
5. Explain rheumatic heart disease and infective endocarditis.
6. Compare and contrast past and present philosophies of the indication of antibiotic premedication for patients with joint replacement.
7. Explain the current recommendations regarding antibiotic premedication for dental procedures according to the American Dental Association and the American Heart Association.
8. Describe the role of the patient’s primary care provider or medical specialist in determining the need for antibiotic premedication for dental patients.
9. Describe the use of lay terms to explain to a patient why premedication with antibiotic is necessary prior to dental appointments.
Provide an overview of what occurs in the body related to blood disorders.
1. Describe oral findings that may be indicative of a blood disorder.
2. Discuss the normal composition of blood.
3. Discuss the terms related to blood disorders.
4. Analyze the differences and similarities of the etiology, signs, symptoms, contraindications, and modification of treatment for iron anemia and megaloblastic anemia: pernicious and folate anemia.
5. Analyze the differences and similarities of the etiology, signs, symptoms, contraindications, and modification of treatment for iron anemia and sickle cell anemia.
6. Analyze the differences and similarities of the etiology, signs, symptoms, treatment contraindications, and modification of treatment for leukopenia and leukocytosis.
7. Analyze the differences and similarities of the etiology, signs, symptoms, contraindications, and modification of treatment for acute leukemia and chronic leukemia.
8. Analyze the differences and similarities of the etiology, signs, symptoms, contraindications, and modification of treatment for polycythemia, hemophiliac XIII, and IX.
9. Analyze the differences and similarities of the terms petechia, purpura, ecchymosis related to blood disorders.
10. Analyze the differences and similarities of the terms leukocytosis and leukopenia.
11. Discuss glossitis and glossodynia relative to anemia.
12. Discuss hematocrit, hematopoiesis, and hemoglobin relative to red blood cells and anemia.
13. Discuss coagulation factors related to blood disorders.
Assess the patient with a blood disorder.
1. Assess medical history for blood disorder problems.
2. Ask appropriate questions and document answers related to blood disorder problems.
3. Identify contraindications for the blood disorder patient.
4. Describe how to alter the DH careplan for the blood disorder patient.
Assess a patient to determine ASA and related risks.
1. Describe the importance of a medical, dental and personal health history.
2. Describe what factors determine the patient’s ASA classification.
3. Utilizing a health history and clinical findings determine the possibility of the patient having an undiagnosed medical condition.
4. Describe how health history and knowledge of vital signs relate to preventing and preparing for medical emergencies.
5. Determine how to utilize the drug book, identify dental related side effects and contraindications for dental treatment.
6. Explain how a patient’s ASA may affect a dental care.
Explain documentation in dental records.
1. Discuss why it is necessary to record complete documentation regarding dates and patient comments.
2. Determine why all entries into a hard copy chart should be in ink.
3. Identify how to make a correction in a dental chart.
4. Explain the legality of documentation in a patient’s chart.
Explain protocol for medical emergencies in the dental clinic.
1. Locate first aid kits, emergency kits and medical equipment in the dental clinic.
2. Describe content of first aid kits and emergency kits in the dental clinic.
3. Describe the procedure to implement for foreign matter in the eye.
4. Describe the procedure to implement for a broken instrument tip intra oral.
5. Describe the procedure to implement for accidental removal of a restoration.
6. Describe the procedure to implement for an instrument puncture.
7. Analyze the differences and similarities for the need for ammonia inhalants and sugar packets at the dental unit.
8. Describe the procedure for a major medical emergency in the dental clinic
9. Describe the treatment procedure for all medical emergencies that may occur in the dental clinic.
Describe how to care for with a patient in need of supplemental oxygen.
1. Describe how to change an empty tank of oxygen.
2. Identify when it is appropriate to administer supplemental oxygen.
3. Describe the steps required to administer supplemental oxygen.
4. Identify the attachments used with an oxygen tank.
5. Describe the criteria the oxygen mask must meet to be effective.
6. Describe the common oxygen delivery devices.
7. Identify four precautions to take when using oxygen.
Describe appropriate first aid for burns.
1. Analyze the differences and similarities of a first, second and third degree burn.
2. Describe the first aid procedures for first, second and third degree burns.
Assess the signs and symptoms of oral, physical, or behavior abuse and neglect of a child, adolescent, adult or geriatric patient.
1. Analyze the differences and similarities of abuse, neglect and dental neglect.
2. Recognize signs and symptoms of suspected neglect or abuse of a child/adolescent/adult/ and geriatric patient.
3. Recognize and describe oral signs and symptoms of suspected neglect or abuse of child/adolescent/adult and geriatric patient.
4. Describe the behavior of the abuser.
5. Describe behavioral indicators of an abused or neglected child.
6. Describe what “PANDA” represents.
7. Discuss the significance of forensic dentistry related to child/adolescent/adult, and geriatric patient abuse.
Describe the legally defined responsibility of reporting suspected child/adolescent/adult/geriatric abuse and neglect.
1. Discuss the protocol to report abuse or neglect.
2. Describe the role of Michigan Children Protective Service.
3. Describe the information needed for making a written report of suspected child/adolescent/adult abuse.
Describe how to assist a physically disabled dental patient.
1. Identify areas of concern when providing a barrier free environment for the dental patient.
2. Describe the external and internal features of the environment to consider for a barrier-free environment for the patient with a physical disability.
3. State the regulation on wheelchair accessibility.
4. Describe the protocol for assisting a wheelchair-bound patient.
5. Describe the importance of proper body mechanics when completing a wheelchair transfer of a patient.
6. Discuss one- and two-person wheelchair transfers of the dental patient.
7. Describe the protocol for assisting a patient who uses a cane, crutches or a walking frame.
Demonstrate protocol for treating an insulin shock (hypoglycemia) emergency in dentistry.
1. Recognize the signs and symptoms of the insulin shock (hypoglycemia).
2. Implement first aid procedures for insulin shock (hypoglycemia).
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating a hyperglycemia emergency in dentistry.
1. Recognize the signs and symptoms of the hyperglycemia.
2. Implement first aid procedures for hyperglycemia.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating a syncope emergency in dentistry.
1. Recognize the signs and symptoms of the syncope.
2. Implement first aid procedures for syncope.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating a hyperventilation emergency in dentistry.
1. Recognize the signs and symptoms of the hyperventilation.
2. Implement first aid procedures for hyperventilation.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating an angina emergency in dentistry.
1. Recognize the signs and symptoms of the angina.
2. Implement first aid procedures for angina.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating an asthma emergency in dentistry.
1. Recognize the signs and symptoms of the asthma.
2. Implement first aid procedures for asthma.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating a motor (tonic-clonic) seizure emergency in dentistry.
1. Recognize the signs and symptoms of seizures.
2. Implement first aid procedures for tonic clonic seizure.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating an allergic reaction emergency in dentistry.
1. Recognize the signs and symptoms of the delayed allergic reaction.
2. Implement first aid procedures for delayed allergic reaction.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating an anaphylaxis emergency in dentistry.
1. Recognize the signs and symptoms of the anaphylaxis.
2. Implement first aid procedures for anaphylaxis.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate protocol for treating a cerebral vascular emergency in dentistry.
1. Recognize the signs and symptoms of the cerebral vascular accident.
2. Implement first aid procedures for cerebral vascular accident.
3. Follow the dental hygiene and college emergency protocol.
4. Provide documentation of the medical emergency.
Demonstrate taking vital signs and provide accurate documentation of the vital sign readings.
1. Demonstrate taking an accurate blood pressure using a cuff and stethoscope.
2. Demonstrate taking blood pressure with a digital blood pressure cuff.
3. Demonstrate taking an accurate respiration rate.
4. Demonstrate taking pulse an accurate pulse rate.
5. Demonstrate taking a temperature using a digital thermometer and record information.
6. Demonstrate taking a temperature using a strip thermometer and record information.
7. Provide accurate documentation of all the vital signs.
Demonstrate wheelchair transfer of a dental patient.
1. Demonstrate the proper body mechanics while demonstrating the procedure for a two-person wheelchair transfer of a dental patient.
2. Demonstrate the proper body mechanics while demonstrating the proper procedure for a one-person wheelchair transfer of a dental patient.
Demonstrate the administration of oxygen and changing of oxygen cylinder.
1. Demonstrate when and how to change the oxygen cylinder.
2. Demonstrate how to administer oxygen.
Demonstrate assessment of the dental patient for risk and prevention of a medical emergency.
1. Provide an accurate medical health history of the patient.
2. Ask appropriate questions and document answers related to health problems.
3. Identify contraindication(s) for the patient.
4. Utilizing professional terminology provide a clear and concise verbal case presentation of the patient’s medical history to a dental professional.
Provide explanation in regard to premedication with antibiotic prior to dental appointments.
1. Utilizing professional terminology, explain to a dental professional when and why premedication with antibiotic may be necessary prior to dental appointments.
2. Utilizing lay terms, explain to a dental patient when and why premedication with antibiotic may be necessary prior to dental care.
3. Explain the role of the patient’s primary care provider or medical specialist in determining the indication of the use of antibiotic premedication.
4. Determine the type and dose of antibiotic needed for a child and adult.
5. Determine the type and dose of antibiotic needed for a patient that has recently been on antibiotic.
6. Answer the patient’s questions using lay terms.