Occupational health and safety emergencies.

When considering potentials emergencies in the dental office, one usually first thinks about potential drug reactions or adverse response to underlying systemic diseases. The rare, but potential, emergencies arising from the office environment itself also exist. Toxic reactions to various chemicals found in the office must be considered also. Adequate ventilation helps prevent the long-term consequences of breathing nitrous oxide and chemclave exhaust. Care must be taken in obtaining complete medical histories. Identify patients with communicable diseases such as TB. The potential for transmission of these infections to office staff and other patients exists. Health histories must include the ability to identify patients with latex sensitivity. The increased use of latex products among health care workers has resulted in a higher incidence of latex sensitivity. The office staff must be prepared to recognize and quickly treat anaphylactic reactions. A latex-free environment must be provided for high-risk patients. Even with the use of universal precautions, blood contamination exposures and needle sticks will still occur. Protect office staff against hepatitis through the administration of a hepatitis prevention vaccine. Establish a protocol in advance for handling blood exposure incidents. Update the patient history to determine potential risk. The exposed individual must receive counseling as to the potential risk of HIV infection. If there is a potential risk of HIV contamination, the exposed individual must be offered the opportunity to initiate prophylactic chemotherapy within 1 hour of exposure. Even though occupational health and safety emergencies are rare, they must be considered and planned for. Contingency plans, such as providing a latex-free environment, must be available for preventing emergencies. The office staff must be prepared to treat immediate emergencies such as anaphylaxis and caustic material spills. Arrangements must be available to quickly handle exposure to communicable infections.