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Four standard vital signs are a person’s:
- Body temperature
- Pulse
- Respiratory rate
- Blood pressure
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Pulse
- Measurement of the heart rate in beats per minute
- The pulse is a throbbing sensation caused by the contraction and expansion of an artery as blood passes through it
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Tachycardia
An unusually fast heartbeat (over 100 bpm in an adult).
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Bradycardia
An unusually slow heartbeat (below 50)
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What is the normal pulse rate for an adult
Normal pulse rate for an adult is between 60 and 100 beats per minute
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Normal pulse rate for a child
- 2-6 years 75-120 Appr. 100
- 6-12 years 75-110 Appr. 95
- Adolesnce to adult 60-100 Appr. 80
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Respiratory rate
- The breathing rate in beats per minute
- Measured by watching the rise and fall of the chest wall
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Normal respiratory rate for an adult/child
- Adult – 14 to 20 breaths per minute
- Child – 18 to 30 breaths per minute
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Blood pressure
The force exerted against the walls of the blood vessels as the blood flows through them
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Prehypertensive blood pressure readings are considered:
- 120 to 139 (systolic)
- 80 to 89 (diastolic)
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Stage 1 hypertension
- 140 to 159 (systolic)
- 90 to 99 (diastolic)
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Stage 2 hypertension
- 160 or higher (systolic)
- 100 or higher(diastolic)
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Purpose of a medical history
- Reveals conditions that may require adaptations or modifications to treatment; also indicates possible precautions
- Systemic disease may have oral implications.
- Medications produce changes in oral health.
- Systemic conditions may require certain precautions prior to dental treatment.
- Oral manifestations may need to be checked by the primary care physician.
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ASA Classifications
- The ASA status of the patient is used to determine the patient’s level of medical risk during dental treatment.
- ASA I-VI
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ASA
The American Society of Anesthesiologists
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ASA II
Mild to moderate disease, anxious
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ASA III
Severe systemic disease that limits activity but is not incapacitated
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ASA IV
Severe systemic disease that is a constant threat to life
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ASA V
A moribund patient not expected to survive 24 hours with or without care.
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ASA VI
Clinically dead patients being maintained for harvesting of organs
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HIPAA
- Health Insurance Portability and Accountability Act.
- Protects all individually identifiable personal health information, or health-related information that can be reasonably linked to a patient using
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Patients that need Prophylactic Premedication
- infective endocarditis
- Artificial heart valves
- A cardiac transplant which develops a problem in a heart valve.
- HHT diagnosis
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Timing of ingestion of oral antibiotics
- (1 hour prior to patient care) ensures adequate concentrations in the blood during, and immediately following, the actual instrumentation.
- The premedication can be taken up to 2 hours after the start of treatment.
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Patient health records assists in
- Coordination of planning
- Continuity of care
- Evaluation of quality of care
- Research & education
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What are the Florida state statues for a patient’s written request for copies of records
A dentist shall comply in a timely manner less than 30 days
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What are the Florida State Statues for record copying fees
- A dentist may charge a fee for copying reports or records not to exceed the cost per page charged by the Clerk of the County Court where the dentist practices.
- The fee for copies of x-rays shall not exceed actual cost of duplication
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50% of emergencies are
syncope
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8% of medical emergencies are
- Mild allergic reaction
- Angina pectoris
- Orthostatic hypotension
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For the Prevention of emergencies Dental Hygienists should take:
- A thorough health history
- Take and record vital signs
- Dental personnel must be prepared for a medical emergencies
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Angina and its treatment
- Inadequate supply of oxygen to the heart
- Nitroglycerine used to treat medical condition
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Asthma and its treatment
- It is an affliction of the respiratory tract
- Stop all dental treatment. Be sure to remove all materials and instruments from the patient’s mouth.
- Place patient in an upright position with arms to allow air to enter the lungs.
- I - Use a bronchodilator
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What are the four stages of the General Tonic-Clonic Seizure – Grand Mal
- Prodromal
- Preictal
- Ictal
- Postical
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Prodromal stage
- The patient may have a personality change or an “aura”. “Aura” can consist of a certain smell, a flash of light, or a certain noise.
- Usually occurs prior to the convulsive stage.
- Begin to time the seizure – 3 minutes is critical
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Preictal phase
the person will lose consciousness and may fall, if standing.
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Ictal phase
Muscle have sustained contractions- “epileptic cry”
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Postical phase
- Patient motion has stopped and they are unconscious.
- Patient may be confused about what happened or where he/she is.
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Absence-Seizure-Petit Mal Seizures
- They may have a blank stare, twitch or blink rapidly.
- Seizure may come and go without anyone realizing the patient is experiencing a seizure.
- Patient resumes normal functioning with no memory of the episode.
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Treatment for seizures
- Place patient in a supine position.
- When the patient regains consciousness reassure them.
- This could take up to two hours.
- Do not give the patient anything to eat or drink until he is fully awake.
- Give the patient plenty of time to rest.
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What are the two stages of syncope
- Cause is fear and anxiety
- First stage the patient is pale and covered in cold sweat.
- Second stage consists of the actual loss of consciousness.
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Treatment of syncope
- Place the patient in a supine position (Trendelenburg) with the feet higher than the head while the patient is in the dental chair (not a pregnant patient).
- Place cold compress on forehead
- Monitor vitals
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Hyperventilation
Hyperventilation syndrome is a condition in which the patient breathes faster and/or deeper than the metabolic needs of the body.
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What is the treatment for Hyperventilation
- Place patient in an upright position & loosen any tight clothing.
- Attempt to keep the patient calm.
- Have patient control breathing.
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What is MI/treatment
- Heart Attack where pain last more than 20 minutes
- Patients are given aspirin.
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What is the treatment for Angina
- Place the patient in a Semisupine or upright position.
- Administer sublingual nitroglycerine –Use patient's own medication if current.
- Will feel tingling sensation on tongue if fresh.
- Administer one table every five minutes up to three doses – usually alleviates symptoms in two to four minutes.
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Symptoms of stroke
- Difficulty with swallowing and speech.
- Once side of face may droop.
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