Medical emergencies and resuscitation audit



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MEDICAL EMERGENCIES AND RESUSCITATION AUDIT

Name…………………………………………………………………………………

G.D.C. No……………………………………………………………………………

Practice Address…………………………………………………………………….


……………………………………………………………………………………….
………………………………………………………………………………………..

Practice Tel. No………………………………………………………………………

Contact Email Address……………………………………………………………….
We suggest that, before you start, you set yourself a % target you would like to achieve, and compare your results to that target.
Target at start of audit…………% compliance with the recommendations of the Resuscitation Council current guidelines.
Once you have completed this audit please let us know any suggestions you may have to improve the format, or any suggestions for future cookbook audits.

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INTRODUCTION.
Dental professionals must ensure that they are able to deal with medical emergencies that may arise in their practice. Such emergencies are, fortunately, a rare occurrence, but it is important to recognise that a medical emergency could happen at any time and that all members of the dental team need to know their role in the event of a medical emergency.”

This statement was taken from the fore-ward of “Medical Emergencies and Resuscitation, Standards for Clinical Practice and Training for Dental Practitioners and Dental Care Professionals in General Dental Practice”.

Available for free download at http://www.resus.org.uk/pages/MEdental.pdf .
It is recommended that you read the aforementioned document before commencing this audit.
AIMS
To ascertain the level of knowledge and compliance with the recommended guidelines.
OBJECTIVES
To identify any areas of knowledge and skills that require further action.
AUDIT
Medical risk assessment.
The taking of full medical histories can help to identify potential problems and modify treatment plans to include hospital referral for some procedures.


  1. Do you regularly take medical and drug histories from patients? Y/N

  2. Does this include questions referring to angina/heart problems? Y/N

  3. Does this include questions referring to asthma/lung problems? Y/N

  4. Does this include questions referring to epilepsy? Y/N

  5. Does this include questions referring to diabetes? Y/N

  6. Does this include questions referring to allergies? Y/N


Method

Initially the drugs and equipment assigned for medical emergencies should be reviewed and then the systems in place need to be assessed to see if they are appropriate and work well. Use this audit as a tool to help with your management of these procedures.


Emergency drugs.
List all of the drugs that are deemed necessary, and the other information in the table below. Please note that the Resuscitation Council (UK) recommends that where possible drugs in solution should be in a prefilled syringe and that all drugs should be stored together in a purposely designed ‘Emergency Drug’ container. They also recommend that the use of intravenous drugs for medical emergencies in general practice is to be discouraged since intramuscular, inhalational, sublingual, buccal and nasal routes are much quicker to administer in an emergency.
Drugs to be available

Drug

Dose

Method of Administration

Date of Expiry

Where kept




















































































































































































































Is a copy of this British Resusitation Council Guidance for Dental practices available within the practice?
Are these drugs stored in a secure way but readily accessible by all staff if needed urgently?
Is an Epipen available for both adults and children?
Is there a spacer device for use with bronchodilating inhalers?
Is the drug container tamper proof (recommended)?
How frequently are these drugs checked?
Do you have a practice protocol for checking these drugs?
Who is responsible, in your practice for the monitoring and safe keeping of these drugs?

Name………………………………………………………. Position in Practice…………………………………………….
Is this person aware of the requirements for keeping and disposing of class 3 controlled drugs such as midazolam buccal solution?
Is this person aware of the requirements for purchase, storage and disposal of class 2 drugs if they are used by the practice?
Is this person aware of how to obtain advice on any area of drugs management from the PCT or Local NHSCB team?
When was the last team meeting about the use and storage of these drugs?

Date of meeting: …………………………………………………………………
Is there clear and simple to understand information available to aid diagnosis of medical emergencies, which drugs should be used and how they need to be administered (recommended)?
How frequently are emergency scenarios acted out to test response time and effective teamwork?

Date of last time: ……………………………………………………………..

Emergency equipment.

Tick if you have this

Condition and date tested

1




2




3




4




5




6




7




8




9




10




The following is the minimum equipment recommended by the Resuscitation Council, please note that 8 and 9 are not mandatory requirements.


    1. Portable oxygen cylinder (D size) with pressure reduction

valve and flowmeter to 15 ltrs a minute.

  1. Oxygen face mask with tubing.

  2. Basic set of oropharyngeal airways (sizes 1,2,3 and 4) and knowledge of how to use them.

  3. Pocket mask with oxygen port as a first line in each surgery.

  4. Self-inflating bag and mask apparatus with oxygen

reservoir and tubing (1 litre size bag) with

variety of well fitting adult and child face masks

for attaching to self-inflating bag.


  1. Portable suction with appropriate suction catheters

and tubing e.g., the Yankauer sucker.

  1. Single use sterile syringes and needles.

  2. Automated blood glucose measurement device.

  3. Automated External Defibrillator.

  4. Do you have protocols in place to ensure that the equipment is replaced if used or when it has passed its expiry date?


References

  1. DPNF

  2. Resuscitation Council (UK)

Standards for Clinicial Practice and Training for Dental Practitioners and Dental Care Professionals in General Practice. www.resus.org.uk
Staff training.


  1. All Staff should undergo regular training (updated yearly) in the management of medical emergencies to a level appropriate to their clinical responsibilities. Y/N

  2. Dental Practitioners and Dental Care Professionals must be trained in cardiopulmonary resuscitation (CPR). Y/N

  3. All training should be documented. Y/N

  4. All medical emergencies should be documented and audited for training purposes. Y/N

  5. The full procedure is rehearsed Y/N

Annual training and retraining is a mandatory requirement for continuing professional development (CPD).



RESULTS.
Do you comply with the recommendations of the Resuscitation Council?

What areas require further attention?


What is your action plan?





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