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      Emergência médica na prática odontológica no Estado de Santa Catarina: ocorrência, equipamentos e drogas, conhecimento e treinamento dos cirurgiões-dentistas Translated title: Medical emergency in dental practice: occurrence, equipments and drugs, professional expertise and training of the clinicians

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          Abstract

          Esta pesquisa teve por objetivo verificar a ocorrência de emergências médicas na prática odontológica, a adequação de equipamentos e drogas, e o nível de conhecimento e treinamento dos profissionais da odontologia no enfrentamento dos eventos emergenciais, tanto no serviço público quanto na clínica privada. Os questionários foram enviados via postal, aos 6.000 cirurgiões-dentistas (CDs) inscritos até abril de 2004 no Conselho Regional de Odontologia do Estado de Santa Catarina. Houve um retorno de 506 questionários (8,43%). A partir da análise dos dados, constatou-se que os CDs respondentes estão conscientes da importância do tema e sentem-se despreparados para solucionar uma emergência médica. As emergências relatadas com maior freqüência foram: lipotimia, taquicardia, hipertensão, reação ao anestésico local e hipoglicemia. O serviço público encontra-se com uma quantidade maior de equipamentos e drogas para emergência médica. Foi enviado, também, ofício às sete instituições de ensino superior com cursos de odontologia no Estado, consulta esta que acusou a inexistência de disciplinas específicas que tratem das emergências médicas. O tema normalmente é abordado em outras disciplinas com pequena carga horária, e nos semestres iniciais do curso.

          Translated abstract

          The aim of this research was to verify the number of occurrences of medical emergencies during the odontological practice; the adequacy of equipments and drugs; the professional knowledge level and training of such professionals in dealing with medical emergencies, both in terms of public health care as well as private practice. Postal questionnaires were sent to 6.000 dentists who were member registered up to April 2004 at the Regional Dental Council of the State of Santa Catarina. There were 506 (8.43%) responses. The analysis of the results revealed that the clinicians who replied were aware on the importance of the issue, and declared themselves not prepared to solve a medical emergency. The most frequent emergencies reported were syncope, tachycardia, hypertension, reaction to local anesthetic and hypoglycemia. The public health service has a larger supply of equipments and drugs for medical emergencies. Official letters were also sent to seven dentistry schools in the state, which answered that there are no specific credits about the subject of medical emergency. Such issue is usually briefly referred in others credits, and in the initial semesters of the course.

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          Medical emergencies in general dental practice in Great Britain. Part 1: Their prevalence over a 10-year period.

          To assess the prevalence, nature and outcome of medical emergencies experienced by general dental practitioners (GDPs) over a 10-year period. Postal questionnaire survey of a random sample of GDPs in Great Britain. 1500 GDPs, 1000 in England & Wales and 500 in Scotland. There was a 74% response. Emergency events were reported by 70.2%: the number reported by a single individual ranged from none to 33. The most commonly experienced events, including those associated with general anaesthesia, were (as a percentage of the total) for England & Wales and Scotland, respectively: fits and seizures (31.0%, 36.3%); swallowed foreign bodies (15.7%, 18.1%); attacks of asthma (13.8%, 11.1%); chest pain associated with angina pectoris (10.1%, 11.0%) and diabetic events (10.6%, 9.0%): none of these resulted in any serious sequelae. More events were reported in Scotland. Overall, there were 20 deaths resulting from medical emergencies reported in the survey, 4 affecting passers-by and none associated with general anaesthesia. 8849 years of practice experience were represented (by 94% of respondents), from which an estimate of the frequency of events was made. An emergency event was reported, on average, for every 4.5 practice years in England & Wales and 3.6 years in Scotland and death associated with general dental practice, on average, once in 758 and 464 years, respectively.
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            The readiness of New Zealand general dental practitioners for medical emergencies.

            A risk of medical emergency accompanies every dental procedure, but little is known of general dental practitioners' readiness for such events. The few previous studies have shown that nearly all dentists have received training in medical emergencies at some time, most of this training being postgraduate. Up to 20 percent of dentists have reported feeling inadequately prepared for medical emergencies, and most are receptive to the idea of receiving further medical emergency-related training. We conducted a postal survey of 314 dentists concerning their readiness for, and experience of, medical emergencies within general dental practice; 199 dentists (63.4 percent) responded. Medical emergencies had occurred in 129 practices (65.2 percent) within the previous 10 years, at a mean rate of 2.0 events per 10,000 patients treated under local analgesia, other forms of pain control, or sedation. Vaso-vagal events had occurred in 121 (61.1 percent) practices within the previous year, the mean rate being 6.9 events per 10,000 patients treated using the same modes. More than half the respondents were dissatisfied with the training they had received for medical emergencies as undergraduate students, and 28 (14.1 percent) currently felt inadequately prepared for an emergency in practice. When asked how their preparedness could be improved, 165 (83.3 percent) opted for hands-on courses, 15 (7.5 percent) opted for lectures alone, and 5 (2.5 percent) opted for other courses alone. One in 20 felt no need for further training. Further training in the management of medical emergencies should be made available to New Zealand's dentists.
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              Medical emergencies in dental practice and choice of emergency drugs and equipment: a survey of Australian dentists.

              P Chapman (1997)
              This is a report of a postal questionnaire survey of 1250 general dental practitioners regarding occurrence of medical emergencies and their choice of emergency drugs and equipment. The response rate was 65 per cent and the results showed that about one in seven practitioners had had to resuscitate a patient. The most common medical emergencies were adverse reactions to local anaesthetics, grand mal seizures, angina pectoris and hypoglycaemia (insulin shock). Nearly all respondents (96 per cent) believed that dentists need to be competent in cardiopulmonary resuscitation, just over a half (55 per cent) felt they were competent in CPR on graduation and a similar figure (57 per cent) felt they could perform effective single person CPR for five minutes. Almost two-thirds (64 per cent) had undertaken CPR courses since graduation. Additionally, the most commonly kept emergency drugs were oxygen (63 per cent) and adrenaline (22 per cent), while the most commonly kept emergency equipment was a manual resuscitator (recoil bag-valve-mask type) which was kept by 27 per cent of the practitioners.
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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                March 2006
                : 11
                : 1
                : 183-190
                Affiliations
                [01] Tubarão SC orgnameUniversidade do Sul de Santa Catarina
                Article
                S1413-81232006000100027 S1413-8123(06)01100127
                60a571a7-86b2-4750-946e-a52af97b2718

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 20 October 2005
                : 17 November 2005
                : 11 April 2005
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 8
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                SciELO Brazil

                Self URI: Texto completo somente em PDF (PT)
                Categories
                Artigos

                Serviço público,Clínica particular,Medical emergency,Equipments,Drugs,Public health care,Private clinics,Emergência médica,Equipamentos,Drogas

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