In a previous article we discussed the importance of preparation in the management of medical emergencies in a dental setting. Here we are going to discuss the all-important documentation to give paramedics ensuring patient safety and a smooth transfer. When emergency teams attend the dental practice it is quite understandable that staff members and in particular the clinician leading the management of the sick patient will be anxious and may well have difficulty recalling all events and actions in an accurate and useful way. This simple single sided A4 document will aid greatly in recording events and details for a more accurate, relevant and professional handover. It consists of four sections.
A Simple Handover Template
Section 1 will include the patients name, date-of-birth, address, telephone numbers, next of kin details, GP details and any relevant medical conditions, medication and allergies.
Section 2 will include practice details (pre-populated), names and designation of those present, dental treatment including time, dose and type of LA if relevant.
Section 3 will include details of the emergency such as time, signs and symptoms.
Section 4 relates to the management. This will include time ambulance called, airway check, position patient placed in, checking of breathing, circulation, blood glucose level, pupil reflex and conscious level using the AVPU scale. Notes should be made on any drugs given including dose, route and timing. Oxygen saturation level and administration should also be recorded. In case of CPR details of compressions, AED and oxygen should be recorded. Finally the time of arrival of paramedics can be recorded.
This handover template not only provides a useful aide memoire during the management of the emergency but also acts as a formal record of events and actions which may be useful evidence and a training resource. All clinical and administration dental staff should be familiar with the template.
Significant Event Analysis
A practice meeting should follow as soon as practical using a significant event analysis template. This will analyse the events of the emergency and identify any future training needs and learning outcomes to help manage or prevent future similar events.
QCS dental members will have access to the handover template next month.