Jing Quan, Wan Kuo, Ma Lin, Zhao Ji Zhi
Department of Dentistry, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Chin Med Sci J. 2020 Dec 31;35(4):342-349. doi: 10.24920/003708.
Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the associated factors for Chinese dentists experiencing medical emergencies.Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018. Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed. The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics. Among them, 85.0% reported that they had encountered medical emergencies, and 35.5% had encountered at least twice. Syncope (35.9%) and hypoglycemia (30.3%) were the most common reported medical emergencies. Medical emergencies were most likely to occur during local anesthesia (49.9%), out-patient oral surgery (25.9%), and root canal treatment (11.3%). There were 6 patients (0.2%) died in emergencies. 84.0% dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support. Longer practicing time (10-15 years) (=0.59, 95% : 0.41-0.85, =0.004), working in private dental facilities (=1.69, 95% : 1.20-2.38, =0.003) were associated with an increased risk of experiencing medical emergencies.Conclusion More efforts are needed in prevention, early identification, and timely management of medical emergencies in dental clinics in order to prevent fatal outcomes. The results of this survey are useful information for re-designing emergency training courses for Chinese dentists.
目的 调查中国牙科诊所医疗急症的特征、发生频率以及中国牙医遭遇医疗急症的相关因素。方法 对2015年12月至2018年12月期间在中国18个城市参加中华口腔医学会镇静镇痛专业委员会举办的继续教育课程的2408名牙医进行了一项调查研究。收集并分析了牙医的人口统计学信息以及他们遇到的医疗急症的特征。通过逻辑回归模型分析了牙医遭遇医疗急症的相关人口统计学特征。结果 共有2013名牙医提供了有效回复,并报告了牙科诊所发生的2923起医疗急症事件。其中,85.0%的人报告称他们曾遇到过医疗急症,35.5%的人至少遇到过两次。晕厥(35.9%)和低血糖(30.3%)是报告中最常见的医疗急症。医疗急症最有可能发生在局部麻醉期间(49.9%)、门诊口腔外科手术期间(25.9%)和根管治疗期间(11.3%)。有6名患者(0.2%)在急症中死亡。84.0%的牙医报告称,除基础生命支持外,他们从未接受过牙科医疗急症管理的培训课程。较长的执业时间(10 - 15年)(比值比 = 0.59,95%置信区间:0.41 - 0.85,P = 0.004)、在私立牙科机构工作(比值比 = 1.69,95%置信区间:1.20 - 2.38,P = 0.003)与遭遇医疗急症的风险增加有关。结论 为预防致命后果,牙科诊所需要在医疗急症的预防、早期识别和及时处理方面做出更多努力。本次调查结果为重新设计中国牙医的急救培训课程提供了有用信息。