DH 112 - Medical Assessment/EmergenciesCredits: 2
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): DH 100 , DH 101 each with a C (2.0) minimum grade, current HCP CPR certification and admission 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 1. Obtain, document, assess and communicate past and present medical and dental histories of a patient with the use of the Physician's
Desk Reference (PDR), and determine the need for treatment modifications. The student will also learn that all patient information and
histories are confidential and legal documents.
A. Define and review the following terms: allergy, antibiotic premedication, bacteremia, drug interaction, forensic, immunocompromised,
informed consent, OTC, PDR, premedication, SBE
B. List the purpose of history taking on forms.
C. State the advantages and disadvantages of the two basic methods of obtaining a medical, dental and personal history.
D. Give examples of different questions asked to classify patient’s status.
E. Review and identify the potential need or chance for the following:
1. antibiotics premedication
2. sedative premedication
3. alteration of treatment
4. emergency care
F. Discuss the questions to be asked at recall appointments to update records.
G. List the four indices of the Physicians Desk Reference (PDR).
H. Obtain information about prescription drugs that the patient is taking by utilizing the PDR.
I. Recognize signs of undiagnosed disease conditions from reports by the client in the health history.
J. Discuss indications for seeking medical consultation regarding the client’s health status.
K. Explain the necessity for accurate record keeping, including:
1. dates
2. record in ink
3. obtain patient signatures on release forms, medical history and other necessary forms.
4. confidentiality.
2. Describe and demonstrate the general rules and body mechanics of a one and two person wheelchair transfer. Describe and provide an
assessable barrier free environment to and from the Dental Hygiene clinic for the patient who uses a cane, crutch, walking frame or
wheelchair.
A. State the regulation on wheelchair accessibility.
B. List at least seven features to consider for a barrier-free environment for the disabled patient.
C. Explain wheelchair transfers.
D. Describe how to assist a patient who uses a cane, crutches, or walking frame.
E. Demonstrate the proper procedure for a two person transfer with 99% competency.
3. Describe the etiology, prevention, signs and symptoms of common cardiac disorders. The students will be able to assess when dental
hygiene care may need modifications, or is contraindicated for patients with cardiac diseases or conditions.
A. Discuss the following conditions and/or diseases (including types, etiology, prevention, signs and symptoms, treatments and emergency
treatment):
1. Congenital Heart Disease
2. Rheumatic Heart Disease
3. Infective Endocarditis
4. Hypertension, Hypertensive Heart Disease
5. Cerebral vascular Accident
6. Hypotension
7. Ischemic Heart Disease
8. Angina Pectoris
9. Myocardial infarction
10. Congestive Heart Failure
11. Sudden Death
12. Cardiac Pacemaker
13. Anticoagulant Therapy
14. Cardiovascular Surgery
B. Explain how and why dental hygiene care might be altered or contraindicated in treating patients with these problems.
C. Review definition of key terms regarding cardiovascular disease.
D. Review definition of:
1. Cerebral vascular accident
2. Ischemia
3. Paralysis
4. TIA
5. State the special obligation that a dental hygienist has to her/his patients.
4. Assess the patient’s vital signs which include pulse, respiration, blood pressure, (using various temperature techniques) and recognize
deviations from the norm.
A. Practice the proper procedure for determining pulse and blood pressure with a clinical partner and attempt the Blood Pressure Task
Analysis with a 98%, 99%, and 100% competency during the course of the semester.
B. Identify various temperature taking options during lab. The student will also take a temperature with at nonmercury-in-glass thermometer
on their clinic partner showing the thermometer and verbally reading the temperature to the instructor during lab time.
C. Define and review each of the following terms: anoxia, apnea, auscultation, bradycardia, diastole, diastolic pressure, hyperthermia,
hypothermia, kortkoff sounds, normotensive, pulse pressure, pyrexia, stethoscope, systole, systolic pressure, tachycardia.
D. List and describe the vital signs and include the normal valves for adults.
E. Describe when it is appropriate to take vital signs.
F. Identify the appropriate equipment utilized for taking vital signs.
G. State the factors that influence pulse rate.
H. Obtain a patient’s radial pulse.
I. Describe the procedure for determining pulse rate.
J. Describe the technique to measure a patient’s respiration.
K. Obtain a patients respiration rate.
L. List and describe the advantages and disadvantage of the three types of manometers.
M. Describe and demonstrate the technique to measure a patient’s blood pressure using an
aneroid or mercury manometer and stethoscope.
N. List the factors that influence blood pressure increase or decrease.
O. List the three methods of taking a temperature.
P. Describe and be familiar with the various types of thermometers in clinic.
Q. Be able to describe normal body temperature of children and adults and temperature variations.
R. Indicate factors that alter body temperature.
S. Obtain a patient’s oral temperature using a mercury in glass thermometer and record the temperature.
5. Locate the clinics medical supplies, deliver oxygen, assist in major and minor emergency care following Delta’s Dental Hygiene
protocol.
A. Define and review each of the following terms: angioneurotic edema, arrhythmia, cardiac arrest, defibrillation, defibrillator, fibrillation,
hypoxemia, syncope, Trendelenburg position.
B. Describe how health history and knowledge of vital signs are related to meeting the client’s human need for safety.
C. Locate the clinic’s medical supplies:
1. Oxygen tank
2. First Aid kits
3. Drugs
4. Bag valve mask resuscitator and CPR mask
5. Instant glucose
6. Fire extinguisher
7. Emergency phone
8. Other
D. Describe the procedure for the following minor clinical emergencies:
1. Calculus or pumice in eye
2. Broken instrument tip
3. Accidental removal of a restoration
4. Instrument puncture (immediate and hematological test recommended)
E. List and explain why one needs padded tongue blades, ammonia inhalants, and sugar packets at your clinic station.
F. Describe the procedure for a major medical emergency in our dental clinic.
G. Describe the treatment procedure for all of the following:
1. Syncope
2. Shock
3. Choking
4. Convulsion
5. Myocardial infarction
6. Insulin shock
7. Diabetic coma
8. Hyperventilation Syndrome
9. Stroke (cerebrovascular accident
10. Burns
11. Internal poisoning
H. Identify the attachments used with an oxygen tank.
I. Describe the common oxygen delivery devices.
J. Identify when it is appropriate to administer supplemental oxygen.
K. Describe the criteria the oxygen mask must meet to be effective.
L. Describe the steps required to administer supplemental oxygen.
M. List four precautions to take when using oxygen.
6. Understand the cause, types, prevention and dental implications of epilepsy, as well as be able to provide the care during a seizure.
A. Define epilepsy.
B. Describe the etiology of seizure/convulsive disorder.
C. List the three basic types of seizures.
D. Describe the signs and symptoms of each seizure (handout).
E. List the drug(s) for the control of epilepsy.
F. Explain what may happen to a patient’s oral condition when they have seizures including if they are on a phenytoin therapy.
G. Define the following terms:
1. Grand Mal
2. Absence, Petit Mal
3. Atonic
4. Autonomic Symptoms
5. Clonic
6. Convulsion
7. Myoclonic
8. Tonic-Clonic
9. Cytpogenic
10. Paresthesia
11. Ataxia
12. Psychic Symptoms
13. Seizure
14. Spasm
15. Status Epilepticus
16. Tonic
17. Aura
18. Automatism
19. Electroencephalography
20. Ictal
21. Prodrome
H. State the examples of precipitating factors.
I. Explain the care that is to be followed if a patient has an epileptic seizure.
7. Understand the oral implications of common blood disorders and state the characteristics of the diseases or conditions and any need
for modifications or contraindications of dental hygiene treatment.
A. Define and review each of the following terms: anaplasia, aplasia, coagulation factor, differential cell count, ecchymosis, epistaxis,
erythropoiesis, glossitis, glossodynia, hemarthrosis, hematocrit, hemoglobin, hemolysis, leukocytosis, leukopenia, lysis, macrocyte,
myelocyte, neutropenia, petechia, phagocytosis, purpura.
B. List the oral findings which may indicate a blood disorder.
C. Review and explain the normal composition of blood.
D. List and state the characteristics of the following blood diseases and conditions:
1. Anemia: a. Iron Deficiency, b. Megaloblastic Anemia (Pernicious Anemia, Folate
Deficiency Anemia), c. Sickle Cell Anemia
2. Polycythemia
3. Leukopenia
4. Leukocytosis
5. Leukemia (Acute and Chronic)
6. Hemorrhagic Disorders: a. Hemophiliacs, b. Miscellaneous
E. Explain how dental hygiene care may be altered or contraindicated with patients having blood disorders.
8. Understand the classifications of Diabetes Mellitus, causes of diabetes and the emergency reactions and treatment. The student will also be able to recognize the oral findings and utilize the appropriate dental hygiene care.
A. Explain each diabetic syndrome classification.
B. Describe in detail the two types of Diabetes Mellitus, including the signs and symptoms and characteristics.
C. Define the characteristics of each term in relationship to diabetes:
1. stable
2. unstable
3. brittle
4. juvenile
5. ketosis
6. adult
7. ketoacidosis
8. gluconeogenesis
9. retinopathy
10. polyphagia
11. polyuria
12. hyperpnea
13. hyperglycemia/hypoglycemia
14. ketone bodies
15. ketonuria
16. OGTT
17. polydipsia
18. pruritus
19. gestational
20. oral hypoglycemic agent
21. insulin
22. mastalgia
D. Describe the difference between diabetes insipidus and diabetes mellitus.
E. Discuss the action of insulin.
F. Explain the effects of Diabetes.
G. List the modes of control and treatment of diabetes; be specific.
H. Discuss how and why it is important to identify patients who might have Diabetes.
I. Discuss in detail the emergency reactions and treatment of reactions that may occur.
J. Explain the oral findings that may occur in diabetes.
K. Describe in detail the measures employed in the dental hygiene care of this special patient.
9. Recognize child abuse and neglect. Including the oral signs and symptoms, the parental attitudes and behaviors which indicated suspected child abuse and neglect. The student will be able to make a written report following protocol of the appropriate agency. The student will assume the legally defined responsibility of reporting suspected child abuse and neglect.
A. Define:
1. Abuse
2. Neglect
3. Dental Neglect
B. Recognize the general signs and symptoms of suspected neglect or abused children.
C. Recognize and describe oral signs and symptoms of suspected neglect or abuse.
D. Describe the parental attitude of the neglected and abused child.
E. Describe Characteristic Behavioral Indicators of Child Abuse.
F. Describe what “PANDA” represents.
G. List the protocol to report abuse or neglect.
H. Describe the role of Michigan Children Protective Service.
I. Describe the information needed for making a written report of suspected child abuse.
10. Describe the etiology, prevention, signs and symptoms, provide emergency treatment and identify necessary treatment modifications for common respiratory emergencies.
A. Describe what occurs within the body when a patient is hyperventilating.
B. Describe what occurs within the body when a patient is experienceing an asthma attack from occurring.
C. List and explain how you would try to preven hyperventilation and asthma attack from
D. Describe the signs, symptoms and treatment procedure for all of the folloiwng:
1. hyperventilation
2. asthma attack
3. COPD
11. Describe the etiology, prevention, signs and symptoms, provide emergency treatment and identify necessary treatment modifications
for common shock emergencies.
A. Describe what occurs within the body when a patient is experiencing syncope.
B. Describe what occurs within the body when a ptaient is experiencin an anaphylactic
C. List and explain how you would try to prevent sycope and anphylactic reactions from occuring
D. Describe the signs, symptoms and treatment procedure for all of the following:
1. syncope
2. anaphylactic reaction
E. Describe the first aid procedures for a person in syncope and anaphylactic shoc.
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