Course DescriptionThe course is designed to cover the causes of various medical emergencies and how to manage an episode in the dental office. Through lectures and reading materials the student will learn about various conditions that can lead to a medical emergency in the dental office, how to recognize it and what management steps are necessary in that particular case. The student is also taught how to prevent a medical emergency from occurring via proper history taking techniques. The course also includes a laboratory project, which involves independent research on a given systemic condition.

Credits/Modes of InstructionThis is a one (1) credit undergraduate course in lecture format that relies on regular activities, assignments, and completion of weekly topics. Prerequisites: Dynamics of Healthcare in Society (For Participating Health Science Careers Program Students)

Instructor: The instructor will be a Rutgers, SHP faculty (or adjunct) member.

Course Objectives:1. Identify the data used to prevent a medical emergency in the dental setting including the patient’s physical state (vital signs) and mental state.

2. Recognize symptoms of medical emergencies which may occur in the dental practice setting or other site, including those related to Metabolic diseases, Cardiopulmonary diseases, Neurological disturbances, Allergic reactions, Visual obstructions, Respiratory disturbances, Shock, Syncope, Emotional disturbances, Thyroid diseases, and Adrenal insufficiency.

3. Identify the procedures necessary to maintain the physiology of respiration and circulation during an emergency.

Department of Interdisciplinary Studies

DENA - 1240

Medical Emergencies in the Dental OfficeRevised 2016 by: Theresa Lennon

4. Identify and carry out general procedures to be followed in case of an emergency:

● Summon aid immediately without alarming the patient or other patients● Reassure the patient and make patient comfortable● Position patient to support circulation and respiration● Initiate required emergency procedures until the dentist or physician arrives.● Describe onset of condition and subsequent signs/symptoms to attending dentist and/or physician● Assist attending dentist and/or physician in administering required emergency treatment

5. Identify the responsibilities and limitations of dental personnel in first aid procedures.

6. Identify the procedures to be provided for a patient with the specific medical emergencies listed in item to be covered in the course.

7. List the essential items needed in the office in case of an emergency.

8. Identify and demonstrate didactic knowledge of use of emergency equipment and drugs.

Course Requirements for Completion:Attendance is required to keep up with the information presented in class. Students will be expected to participate in classroom discussions and group activities. Each course unit will include readings, assignments, and a short quiz as developed by high school faculty. In addition, successful completion the course projects will be required. There will be a cumulative final exam based on class content and assigned readings

Evaluation/Assessment Methods:20% Attendance/Participation/Group Discussion – Students are expected to attend all classes and participate in classroom

discussions and group activities.

20% Unit Quizzes – Students will be required to take a short quiz at the completion of each unit. Content will be based on lectures, readings, and classroom discussions/activities - as developed by high school faculty.

30% Unit Assignments – Each unit will have specific assignments geared to meet unit objectives. These assignments can be completed as homework or in class, as time permits determined by high school faculty.

30% Course Exams/Projects/Practical Drills – as assigned by high school faculty

Final high school grade is calculated as described above and determined by high school faculty.

Final Examination (developed and administered and by Rutgers-SHP) – Successful completion of a cumulative final exam at the end of the course is required and will determine college credit grade.

Upon successful completion of the course students will be eligible to take the Health Science Careers standardized exam to determine college credit. High school students must attain a C (73) or better on standardized exam to earn college credits. The Rutgers grade listed on transcript will be comprised of 50% of the Rutgers, SHP standardized exam grade and 50% high school grade.

Health Science Careers Program Grading System

Weighted Average of All

Requirements

FinalLetterGrade

93-100 A

90-92.9 A-

87-89.9 B+

83-86.9 B

80-82.9 B-

77-79.9 C+

73-76.9 C

70-72.9 C-

67-69.9 D+

63-66.9 D

Less than 63 F

Faculty/Student Honor Code:

(Refer to the Rutgers Student Handbook at http://rutgers.SHP.edu/current_students/handbook.pdf)

The faculty of Rutgers, School of Health Related Professions believe that students must observe and support high standards of honesty and integrity in all aspects of education, practice, and research. For this reason, all matriculated and non-matriculated students in this course are expected to abide by the School's Faculty/Student Honor Code and accept responsibility to help ensure that these standards are maintained by reporting violations of the Honor Code observed in others. All violations will be considered with gravest concern and may be punishable with sanctions as severe as suspension or dismissal.

General Learning ResourcesRequired Textbook(s):Malamed. Medical Emergencies in the Dental Office. Mosby, Inc., an affiliate of Elsevier Inc. 3251 Riverport Lane, St. Louis, MI. 7th Edition. 2015. ISBN: 9780323171229

Highly Recommended:Lippincott Williams & Wilkins' Comprehensive Dental Assisting. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012. (ISBN:13:978-1-582-55815-8)

Other Required Learning ResourcesVarious website links will be provided in the Learning Resources section for each unit in the Course Schedule. Students are required to access these websites for completion of assigned readings and activities.

Course Units/ScheduleNote: this schedule is a plan only, subject to change by the instructor as deemed necessary to achieve the course goals. Whenever possible, you will be notified in advance of any changes, especially those affecting course requirements or grading.

Unit/Begin Date

Topical Outline Activities/Assignments NJCCCS

Unit 1 INTRODUCTION, PREVENTION, and PREPAREDNESS

Discuss factors increasing risk during dental treatment

Identify methods of classification of life-threatening situations

Identify the most common medical emergencies in a dental office

Explain why medical history is important in preventing an emergency;

State the significance of vital signs;

Define ASA classification;

Describe stress reduction protocol.

Identify emergency plans for the dental office;

List the items included in

Introduction

1. Reading Ch 1 2. Video Introduction - 3. Lesson – Cornell Notes4. Guided Reading 1.15. Define Key Terms 1.16. Discussion7. Quiz 1.1

Prevention

1. Video Discussion – Types of Death2. Lesson – Cornell Notes3. Guided Reading 1.24. Define Key Terms 1.25. Web Quest – Medical History6. Recall Vital Signs7. Group Activity - Medical History Scenarios 8. Worksheet – ASA Classifications9. Quiz 1.2

Preparation

1. CPR Review Worksheet

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a medical emergency kit; Explain which emergency

drugs are necessary in the office and describe the use of each drug.

2. PPT Lesson3. Guided Reading 1.34. Define Key Terms 1.35. Role Play Emergency Team Drills p65-666. Quiz 1.3

Unit Test 1Unit 2 UNCONSCIOUSNESS

Recognize unconsciousness based on the three assessment criteria;

Manage the unconscious victim;

Explain the importance of baseline blood pressure;

Discuss the physiological consequences of hypotension;

List the steps in the management of hypotension;

Discuss the causes of hypotension;

State ways to prevent hypotensive episodes in the dental office.

Name what other disorders can mimic adrenal insufficiency;

Describe the anatomy of adrenal gland;

Unconsciousness

1. Video Discussion - 2. Lesson - Notes3. Define Key Terms 2.14. Practice Skills Introduction5. Quiz 2.1

Vasodepressor Syncope and Postural Hypotension

1. Video Discussion - 2. PPT Lesson 2.23. Practice Skills Rubrics4. Quiz 2.2

Adrenal Insufficiency

1. Discussion - Stress2. PPT Lesson3. Guided Reading4. Emergency Protocol

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Explain steroid therapy and rule of twos;

Dental treatment complications and considerations;

Discuss emergency management protocol for an adrenal related emergency;

List the predisposing factors to acute adrenal insufficiency;

Discuss the differential diagnosis of adrenal insufficiency;

Explain the use of corticosteroid therapy for adrenal disorders.

Unit 3 RESPIRATORY DISTRESS:

Define terms related to respiratory distress;

Discuss potential causes of respiratory distress:

and list the basic steps to manage most types of respiratory distress.

Define hyperventilation

Discuss causes of

Respiratory Distress and Foreign Body Airway Obstruction

1. CPR Review Worksheet2. PPT Lesson 3.13. Guided Reading 3.14. Define Key Terms 3.15. Google Classroom – Essential Question discussion6. Quiz 3.1

Hyperventilation

1. Video Discussion - https://www.youtube.com/watch?v=p97HeXx0vN0#t=59

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hyperventilation State the signs and

symptoms of hyperventilation

Discuss prevention of hyperventilation

State management protocol of hyperventilation in the dental office

List conditions that may mimic hyperventilation

List signs and symptoms of wheezing

Define asthma State what may cause

respiratory distress List the signs and

symptoms of asthma Name the medications

that may be used to manage asthma

Discuss the steps for prevention of an asthmatic episode

Discuss the protocol for management of an asthmatic episode

Define status asthmaticus

2. PPT Lesson 3.23. Practice Skills Rubric 3.24. Google Classroom – Edpuzzle video with questions

Asthma

1. Video Discussion -

http://www.mayoclinic.org/diseases-conditions/asthma-attack/multimedia/asthma/vid-20084746

2. PPT Lesson 3.33. Key Terms 3.34. Practice Skills Rubric 3.35. Google Classroom – Edpuzzle video with questions6. Quiz 3.2-3

Heart Failure and Acute Pulmonary Edema

1 Video Discussion - http://www.pbs.org/wgbh/nova/body/map-human-heart.html2 PPT Lesson 3.43 Define Key Terms 3.44 Google Classroom – Heart Failure Webquest5 Google Classroom – Edpuzzle video6 Quiz 3.4

THR.4

State the protocol for management of status asthmaticus

List other conditions that may mimic asthma

Define dyspnea State the signs and

symptoms of dyspnea Discuss causes of

dyspnea State the dental

treatment modalities for MI, angina, CHF

Define angioplasty Discuss necessity for

angioplasty Define bypass surgery State the rationale for

medical consult protocol

Discuss valvular disorders

Define regurgitation Explain the rationale

for antibiotic premedication

Define SBE Define Congestive

Heart Failure Discuss causes of

congestive heart failure

Discuss physiological effect of Congestive Heart Failure

List medications of Congestive Heart Failure patient

Discuss treatment modifications for the CHF patient

Unit 4 ALTERED CONSCIOUSNESS Define altered mental

status Discuss various causes of

altered mental status Describe the physiology

of the pancreas Describe abnormalities

that may occur in the pancreas

Differentiate between the types of diabetes

List the medications used to manage diabetes

Discuss physiological manifestations of diabetes

Discuss management of hypo or hyperglycemic episode in the dental office

Altered Consciousness and Mental Status

1. PPT Lesson 4.12. Define Key Terms 4.13. Google Classroom – Ingestion or Administration of Drugs Essential

Question

Diabetes Mellitus

1 Video Introduction - https://www.youtube.com/watch?v=4YZrDJB6_GQ

2 PPT Lesson 4.23 Guided Reading 4.24 Practice Skills Rubric 4.25 Quiz 4.2

Thyroid Disorders

1 PPT Lesson 4.32 Define Key Terms 4.33 Guided Practice – Clipboard Review. Divide students into 4 teams.

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Discuss anatomy and function of thyroid gland

List Signs and symptoms of hypo and hyperthyroidism

Discuss the importance of a thorough medical history review

State the dental treatment protocol: Medical history consult, Dental contraindications, and Epinephrine use

Discuss management of thyroid emergency in the dental office

Define stroke Discuss causes of stroke Define TIA Differentiate between the

types of stroke: Hemorrhagic and Occlusive

Discuss the important and rationale of a medical consult

Discuss proper waiting period before treating patient with history of stroke

List signs and symptoms of stroke

Describe the steps

Give each team a copy of the “Clipboard Relay” handout on a clipboard. As the clipboard is passed down the row, each student is to write in a sign or symptoms of thyroid emergencies.

Cerebrovascular Accident

1. PPT Lesson 4.42. Define Key Terms 4.43. Practice Skills Rubric 4.44. Quiz 4.4

necessary to manage a stroke in the dental office: ABC, BLS, and EMS

UNIT 5

SEIZURES Discuss the types of

seizures Identify clinical signs and

symptoms State predisposing factors

for a seizure Discuss the importance of

a medical history review State dental therapy

considerations Explain the management

of an epileptic seizure in the dental office

Discuss Status epilepticus Explain why a static

GTCS is a true medical emergency

Discuss the management of status seizures in dental office

State medications to administer in the event of a static seizure

Seizures

1. Video - http://www.epilepsy.com/atom/80412. PPT Lesson 53. Define Key Terms 54. Webquest -

http://www.epilepsy.com/get-help/managing-your-epilepsy/understanding-seizures-and-emergencies/warning-signs-seizures

5. Practice Skills Rubric 56. Quiz 5

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UNIT 6

DRUG RELATED EMERGENCIES

Drug Overdose Allergy

1. Video - https://www.epipen.com/about%20epipen/auvi%20q%20recall

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and Anaphylaxis Discuss what IgE is and

its role in allergic reactions

Name the types of allergies and their differences

Define anaphylaxis State the signs and

symptoms of anaphylaxis Name the causes of an

anaphylactic reaction Explain the management

of allergic reactions Discuss the importance of

a medical history in the prevention of an allergic reactions

List drugs that may cause allergic reactions

List the signs of sedation Name sedative

medications available for use in the dental office

Describe signs of oversedation

Name the drugs to reverse oversedation

Discuss management protocol of an emergency involving oversedation

2. PPT Lesson 63. Define Key Terms 64. Practice Skills Rubric 65. Quiz 6

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UNIT 7

CHEST PAIN Define chest pain

State the causes of chest pain

Discuss genetic and non-genetic predisposing factors for heart disease

Discussion of importance of medical history in prevention of a cardiac emergency

Name the signs and symptoms of chest pain

Discuss management of chest pain in the office

Name the medications used to manage angina

List the signs and symptoms of angina

State the management protocol for management of angina in the dental office

Discuss the importance of prevention of an angina emergency in the dental office

Define Palpitations and Dysrhythmias

Angina, Acute MI, and Chest Pain

1 Video Discussion - Angina2 Define Key Terms 73 Google Classroom – Angina VS. Myocardial Infarction4 Practice Skills Rubric 7

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Discuss causes of Palpitations and Dysrhythmias

Define coronary artery disease

Discuss manifestations of coronary artery disease

Define cardiac arrest Define clinical death

Define biological death

Differentiate between clinical and biological death

Describe the links in the chain of survival

Outline the benefits and use of an AED

Differentiate between pulmonary and respiratory arrest

State the steps in the management of an acute MI

UNIT 8

LEGALITIES Define Tort Law Discuss legal aspect of

Legalities

1. PPT Lesson 8

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duty to treat Discuss necessity of

informed consent Discuss ethics in dental

office Define Beneficence Define Nonmalfeasence Define Discrimination Discuss legal issues

regarding a multipractitioner office

Discuss legal issues of being prepared for an emergency

2. Guided Reading 83. Google Classroom – Essential Question discussion4. Quiz

UNIT 9

PEDIATRIC Review stages of child

development Review differences in

child vs adult anatomy Discuss common

pediatric emergencies in the dental office

Discuss management of common pediatric emergencies

Pediatric Emergencies

1. Discuaaion

http://www.aapd.org/media/policies_guidelines/rs_medemergencies.pdf

2. PPT Lesson 93. Guided Reading 94. Google Classroom – Essential Question discussion5. Quiz

FINAL EXAM

TBA