Obata Kyoichi, Naito Hiromichi, Yakushiji Hiromasa, Obara Takafumi, Ono Kisho, Nojima Tsuyoshi, Tsukahara Kohei, Yamada Taihei, Sasaki Akira, Nakao Atsunori
Department of Oral and Maxillofacial Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan.
Department of Emergency, Critical Care and Disaster Medicine Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan.
Acute Med Surg. 2021 May 1;8(1):e651. doi: 10.1002/ams2.651. eCollection 2021 Jan-Dec.
Although uncommon, medical emergencies arise in general dental practice. Inadequate data on their severity and frequency makes targeting medical education for general dental practitioners difficult. This also makes planning for unexpected events challenging for practitioners and makes collaborating with emergency physicians burdensome. We aimed to clarify the incidence and characteristics of a dental outpatient department's medical emergencies.
This single-center, retrospective, observational study was undertaken with patients who visited the dental outpatient department of Okayama University Hospital during the 8-year period. The primary outcome of the study was to identify the incidence and characteristics of medical emergencies in the dental outpatient department. Then we examined the timing of medical emergencies, administered medications, and final disposition (home/admission).
During the period, 1,146,929 patients were enrolled. Forty-two patients (0.0037%) were consulted as medical emergencies. More than 60% of the incidents were vasovagal syncope, and dehydration and hypoglycemia were the second most prevalent at 9.5%. The most common types of dental treatments were tooth extraction (45.2%), followed by general dental treatment (28.6%), and other dental surgery such as implant placement (14.3%). Types of medical emergencies occurred equally before, during, and after dental treatment. Antihypertensive agents, sedatives, or glucose were used. For patients with emergencies, 90.5% recovered during the day and returned home, and 9.5% were hospitalized.
The incidence of medical emergencies was low in our dental outpatient department. Knowledge of basic management principles, regular education for emergency care, and practicing first aid skills are mandatory for safe patient management.
虽然罕见,但普通牙科诊疗中会出现医疗紧急情况。关于其严重程度和发生频率的数据不足,使得针对普通牙科医生的医学教育难以有的放矢。这也使得从业者对突发事件的规划具有挑战性,且与急诊医生的协作负担沉重。我们旨在阐明牙科门诊部医疗紧急情况的发生率和特征。
本单中心、回顾性观察研究纳入了在8年期间到冈山大学医院牙科门诊部就诊的患者。该研究的主要结果是确定牙科门诊部医疗紧急情况的发生率和特征。然后我们检查了医疗紧急情况发生的时间、所使用的药物以及最终处置情况(回家/住院)。
在此期间,共纳入1,146,929名患者。有42名患者(0.0037%)因医疗紧急情况前来咨询。超过60%的事件为血管迷走性晕厥,脱水和低血糖次之,占9.5%。最常见的牙科治疗类型是拔牙(45.2%),其次是普通牙科治疗(28.6%),以及其他牙科手术如种植牙植入(14.3%)。医疗紧急情况在牙科治疗前、治疗期间和治疗后均有发生。使用了抗高血压药物、镇静剂或葡萄糖。对于出现紧急情况的患者,90.5%在当天康复并回家,9.5%住院治疗。
我们牙科门诊部医疗紧急情况的发生率较低。掌握基本管理原则、定期接受急救护理教育以及练习急救技能是安全管理患者的必备条件。