128

Clinical Sedation in Dentistry

sedation is never so urgent as to put the patients life at risk

from inadequate assessment and planning.
Adherence to the principles of good sedation practice
should minimise the incidence of problems. However,
despite careful preparation and technique, complications
and emergencies can still arise. This chapter will discuss the
emergency equipment and drugs required when practising
sedation, the aetiology, clinical features and management of
specific sedation-related problems and medical emergencies
and the prevention and treatment of local complications.
In July 2006, the Resuscitation Council (UK) published
guidelines specific to dental practice dealing with the
management of medical emergencies and resuscitation.
The guiding principles of this document state:
Medical emergencies can happen at any time in dental
practice. If you employ, manage or lead a team, you should
make sure that:
There are arrangements for at least two people to be
available to deal with medical emergencies when treatment
is planned to take place.
All members of staff, not just the registered team members,
know their role if a patient collapses or there is another kind
of medical emergency.
All members of staff who might be involved in dealing with
a medical emergency are trained and prepared to deal
with such an emergency at any time and practise together
regularly in a simulated emergency so they know exactly
what to do.
This chapter will consider the management of general medical
emergencies and specific sedation-related emergencies with
reference to the adult patient. With regard to the management
of children, readers should access the Resuscitation Council
(UK) website and their own National Drug Formulary for
paediatric drug doses.

EMERGENCY EQUIPMENT
It is recommended by the Resuscitation Council (UK) that the
equipment used for any medical emergency or cardiopulmonary
arrest should be standardised throughout general dental
practices. All clinical areas should have immediate access to
resuscitation drugs, equipment for airway management and an
automated external defibrillator (AED). Staff must be familiar
with the location of all resuscitation equipment within their
working area. The necessary equipment is illustrated in Table 8.1.