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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 46-49

Evaluation of knowledge, experience, and perception about medical emergencies among dental graduates (interns)


Department of Oral and Maxillofacial Surgery, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Submission06-Oct-2021
Date of Acceptance06-Oct-2021
Date of Web Publication29-Nov-2021

Correspondence Address:
Dr. Geerthana Muthu
Department of Oral and Maxillofacial Surgery, Sri Ramachandra Dental College and Hospital,Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijosr.ijosr_9_21

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  Abstract 


Introduction: The study is based on the effective management of an emergency situation in the dental office. The lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legal action. For this reason, all health professionals including dentists must be well prepared to attend to medical emergencies. Providing basic life support (BLS) is the dentist's most important contribution until definitive treatment for a medical emergency can be given. The aim of the study is to evaluate the knowledge, experience, and perception about medical emergencies among dental graduates (interns). Materials and Methods: Data were collected from 100 Interns of Private Dental College of Chennai, India, by using a structured questionnaire consisting of the 7-item questionnaire (6 closed and 1 open). Statistical analysis was performed to analyze the study. Results: Among 100 dental students, who participated in the following study, only 70% of them were aware of the medical emergency drugs and their uses, the confidence level of the students was abruptly good in those students and 30% of the students should improve the level of confidence in using and handling of the drugs. Conclusion: The study is useful to gain knowledge for dental students in case of medical emergency situations.

Keywords: Basic life support, dental graduates, medical emergencies


How to cite this article:
Muthu G, Deepak C. Evaluation of knowledge, experience, and perception about medical emergencies among dental graduates (interns). Int J Soc Rehabil 2021;6:46-9

How to cite this URL:
Muthu G, Deepak C. Evaluation of knowledge, experience, and perception about medical emergencies among dental graduates (interns). Int J Soc Rehabil [serial online] 2021 [cited 2022 Aug 10];6:46-9. Available from: https://www.ijsocialrehab.com/text.asp?2021/6/1/46/331483




  Introduction Top


Medical emergencies can be alarming to any clinician, but these situations are less alarming if proper preparations are made. Medical emergencies occur in dental practice more frequently. Fortunately, serious medical emergencies in dental practice are not common, but they are all the more alarming when they occur. A thorough patient history can draw the practitioner's attention to potential medical emergencies that could occur.[1] Changing demographics in the population leading to increased longevity have led the people having medical conditions which predispose to a medical emergency or taking medication may influence their dental management and persons aged above 65 years or over are considered to be taking medication with a potential effect on dental care. An increasing proportion of the population is medically at risk. According to the European Resuscitation Council, sudden cardiac arrest is a leading cause of death in Europe, affecting about 700,000 individuals a year. Thus, effective management of an emergency situation in the dental office is ultimately the dentist's responsibility.[2] Although a number of studies have been carried out which sought to ascertain the emergency drugs and equipment, the lack of training and inability to cope with medical emergencies can lead to tragic consequences and sometimes legation action. For this reason, as health professionals, dentists should be well prepared to collaborate with medical emergencies.[3] Providing basic life support (BLS) is the dentists' most important contribution until definitive treatment for a medical emergency can be provided. Few studies described how the dentists consider themselves in managing medical emergency situations, and very few studies to our knowledge have reported studies involving fresh dental graduates.[4] The aim of this study is to learn the experience of handling medical emergencies, their skills and competency, and how well they felt are prepared to manage such events with appropriate use of drugs and equipment in a dental setting.[5]


  Materials and Methods Top


A cross-sectional questionnaire approach was chosen to probe dental graduates' (Interns) knowledge, experience, and perceptions of medical emergency in the dental office. This research was conducted at Private Dental College, Chennai, India, during the academic year 2016. A total of hundred and five (105) Bachelor of dental surgery graduates from the respective Saveetha Dental College, who were undergoing the Internship and who could look back over their experiences regarding the dental medical emergency were volunteered to participate, with an invitation issued in the college. Respondents were told the study was completely confidential and encouraged to answer a 7-item pretested questionnaire (6 closed-ended and 1 open-ended) which was in a tick box format. Data collection procedures followed the standards of the Saveetha Dental College students and all the graduates (Interns) signed a consent form.[6] The purpose of this study was to evaluate the dental graduates, knowledge, experience, and perceptions regarding medical emergencies in the dental practice. The questionnaire sought information on the frequency and type of medical emergencies encountered by the interns in the past 4 years. The knowledge, confidence of administering the essential drugs, and equipment required to be in the emergency drug box.[7] The amount of medical emergencies training undertaken by participants on the past 4 years and what percent of this was BLS training.[8] If participants felt that more training in general medical emergencies is required, data were collected from the various aspects.


  Results Top


Hundred dental graduates answered the questionnaire. Sixty-one of 105 (58.1%) had experienced an emergency situation during their graduation. Syncope/faint was seen by 40.9% of the respondents, 37.1% with hypoglycemic attacks, allergic reactions by 17.1%, epileptic attacks by 7.6%, asthmatic attacks by 4.5%, and angina 0.9%. The frequencies of the emergencies encountered were once or even more [Table 1] and [Table 2] shows the percentage of dental graduates about the knowledge of identifying the recommended drugs, essential pieces of equipment in the emergency kit, and the confidence of using them.[9] Forty-five out of hundred (42.9%) had received no medical emergency training, and the remaining sixty (57.1%) had received a medical emergency and BLS training for <5 h. Hundred and two graduates (97.1%) felt the need for more medical emergencies training [Table 3] shows the competency in the areas of drug administration/other procedures. From an open-ended question, we observed that the knowledge of the dental graduates (Interns) was at an acceptable level as majority of them expressed to terminate the treatment and activate the emergency services (EMS) when any emergency situation in the dental office occurs.[10]
Table 1: Essential drugs recommended being present in the drug kit and the level of confidence in using them (%)

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Table 2: Essential equipment recommended being present in the kit and the level of confidence in using them (%)

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Table 3: Do you feel competent in the following areas? (%)

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  Discussion Top


The results of this study confirmed that the dental graduates (Interns) are not capable of competently managing a medical emergency and perceived a need for more intensive education in medical emergencies, and they strongly desire to obtain this knowledge.[11],[12] Several studies have assessed qualified dental surgeons on the management of medical emergencies,[5],[13],[14],[15] but to our knowledge, there is no reported study involving fresh dental graduates (Interns). Hence, this cohort was targeted to probe and quantify the perceptions of medical emergency in the dental office. Although there have been relatively few studies carried out regarding medical emergencies in dental hospitals, our study results show that the proportion of specific medical emergency events occurring were similar with those studies.[8],[13],[16] The most commonly encountered emergencies seen by the Interns in both the colleges were syncope/faints, followed by asthmatic and hypoglycemic attacks.[11] This would indicate that the training should be focused on dealing with these emergencies. A higher frequency 61 (58.1%) respondents had faced a life-threatening situation in the study contrary to the studies.[3],[7],[13] The reason for the differences in the frequency/total number of emergency could be explained by having several persons reporting the same event occurring in the dental school more than once.[16] There has not been any published data regarding emergency drugs and equipment recommendations against which we can compare our results. The guidelines differ in recommended drug and equipment, but when a direct comparison is made between commonly recommended emergency drugs conclusions can be drawn. We found that respondents in our study had good knowledge in identifying the four common drugs such as adrenaline, glucose, oxygen, and glycerlytrinitrate. The knowledge was not at an acceptable level, particularly when discussing drugs such as midazolam, prednisolone, and chlorpheniramine maleate, and very few respondents recognized these as being essential drugs[7],[8] [Table 1]. Similar results were found when investigating the level of knowledge regarding emergency equipment. Single-use syringes, oxygen face mask, and blood glucose measurement devices were recognized to some extent and lowered knowledge was seen regarding equipment such as pocket masks, portable suction and self-inflating child, and adult bag valve mask[8],[17] [Table 2]. The confidence in the use of drugs and equipment mentioned were at a very lower level than the knowledge for all the drugs and equipment mentioned.[18] This suggests that although training is received in the theoretical aspect of emergencies, participants are not particularly confident to treat emergencies and may require further practical training [Tables 1-3]. From the responses regarding the number of hours of medical emergencies training undertaken in the undergraduate curriculum, it is evident that there are more definitive guidelines regarding the number of hours of training is recommended. Only 57% of respondents had undergone medical emergency and BLS training for <5 h which was very low. The result may be due to the lack of definitive guidelines about the training with medical emergencies in the dental curriculum.[8] Overall in the study, a large number of graduates stated that they did not know how to proceed in those situations even though they received training in the management of medical emergencies at some time, they expressed the need for further medical emergencies training.[3],[11],[7],[8],[13],[19]


  Conclusion Top


The study showed that syncope is the most common medical emergency event and the others are hypoglycemic attacks, allergic reactions, epileptic attacks, and asthmatic attacks. All in all, dental graduates had a superficial knowledge of medical emergencies, drugs, and equipment, and they expect this topic should be an integral part of their curriculum.[12] A majority of them perceived the need for further training by means of hands-on courses. The study has allowed to find deficiencies in the way the dentists were trained dealing with medical emergencies and identify a need for improvement, be by increasing the volume and quality of training which undergraduates perceive to enhance their capability to recognize and manage a medical emergency and to become well-qualified practitioners.[20]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Greenwood M. Medical emergencies in the dental practice. Periodontol 2000 2008;46:27-41.  Back to cited text no. 1
    
2.
Coulthard P, Bridgman CM, Larkin A, Worthington HV. Appropriateness of a resuscitation council (UK) advanced life support course for primary care dentists. Br Dent J 2000;188:507-12.  Back to cited text no. 2
    
3.
Atherton GJ, McCaul JA, Williams SA. Medical emergencies in general dental practice in Great Britain. Part 1: Their prevalence over a 10-year period. Br Dent J 1999;186:72-9.  Back to cited text no. 3
    
4.
Gonzaga HF, Buso L, Jorge MA, Gonzaga LH, Chaves MD, Almedia OP. Evaluation of knowledge and experience of dentists of São Paulo State, Brazil about cardiopulmonary resuscitation. Braz Dent J 2003;14:220-2.  Back to cited text no. 4
    
5.
Laurent F, Augustin P. Managing a cardiac arrest: Evaluation of 4. Final year predoctoral dental students. J Dent Educ 2009;73:211-8.  Back to cited text no. 5
    
6.
Ahamed A, Kumar MP. Knowledge, attitude and perceived confidence in handling medical emergencies among dental students. J Pharm Sci Res 2016;8:645-9.  Back to cited text no. 6
    
7.
Champman PJ. A questionnaire survey of dentists regarding knowledge and perceived competence in resuscitation and occurrence of resuscitation emergencies. Aust Dent J 1995;40:98-103.  Back to cited text no. 7
    
8.
McCarthy FM. Emergency drugs and devices--less is more. J Calif Dent Assoc 1993;21:19-25.  Back to cited text no. 8
    
9.
Leelavathy L, Reddy C, Elizabeth CP, Priyadarshni I. Experience, awareness, and perceptions about medical emergencies among dental interns of Chennai city, India- A questionnaire based study. J Indian Assoc Public Health Dent 2016;14:440.  Back to cited text no. 9
    
10.
Gupta T, Aradhya MR, Nagaraj A. Preparedness for management of medical emergencies among dentists in Udupi and Mangalore, India. J Contemp Dent Pract 2008;9:92-9.  Back to cited text no. 10
    
11.
Carvalho RM, Costa LR, Marcelo VC. Brazilian dental students' perceptions about medical emergencies: A qualitative exploratory study. J Dent Educ 2008;72:1343-6.  Back to cited text no. 11
    
12.
James DW. General anaesthesia, sedation and resuscitation in dentistry. Br Dent J 1991;171:345-7.  Back to cited text no. 12
    
13.
Atherton GJ, McCaul JA, Williams SA. Medical emergencies in general dental practice in Great Britain. Part 2: Drugs and equipment possessed by GDPs and used in the management of emergencies. Br Dent J 1999;186:125-30.  Back to cited text no. 13
    
14.
Broadbent JM, Thomson WM. The readiness of New Zealand general dental practitioners for medical emergencies. N Z Dent J 2001;97:82-6.  Back to cited text no. 14
    
15.
Atherton GJ, Pemberton MN, Thornhill MH. Medical emergencies: The experience of staff of a UK dental teaching hospital. Br Dent J 2000;188:320-4.  Back to cited text no. 15
    
16.
Haas DA. Management of medical emergencies in the dental office: Conditions in each country, the extent of treatment by the dentist. Anesth Prog 2006;53:20-4.  Back to cited text no. 16
    
17.
Adewole RA, Sote EO, Oke DA, Agbelusi AG. An assessment of the competence and experience of dentists with the management of medical emergencies in a Nigerian teaching hospital. Nig Q J Hosp Med 2009;19:190-4.  Back to cited text no. 17
    
18.
Chapman PJ. Medical emergencies in dental practice and choice of emergency drugs and equipment: A survey of Australian dentists. Aust Dent J 1997;42:103-8.  Back to cited text no. 18
    
19.
Chate RA. Evaluation of a dental practice cardio-pulmonary resuscitation training scheme. Br Dent J 1996;181:416-20.  Back to cited text no. 19
    
20.
Atherton GJ, McCaul JA, Williams SA. Medical emergencies in general dental practice in Great Britain. Part 3: Perceptions of training and competence of GDPs in their management. Br Dent J 1999;186:234-7.  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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