Medical Emergencies and Sedation
What this domain tests
This domain tests recognition and team-based management of syncope, anaphylaxis, asthma, angina, hypoglycaemia, seizures, choking and cardiac arrest, plus safe conscious sedation under Dental Council guidance.
Core rules and concepts
- Risk-assess every patient; keep emergency drugs and equipment checked and in date; train the whole team regularly.
- Basic life support and an AED are core skills. Summon help early and call 999 when needed.
- Anaphylaxis: give intramuscular adrenaline 0.5 mg of 1:1000 solution for an adult, call 999, give oxygen and monitor; do not delay for antihistamines.
- Vasovagal syncope: lay the patient supine with legs raised, ensure airway, give oxygen if needed and monitor recovery.
- Conscious sedation requires patient selection, consent, fasting according to protocol, continuous monitoring, a trained escort and documented recovery. Capnography and oxygen saturation monitoring are expected for intravenous sedation.
Worked example
A patient becomes pale and clammy shortly after local anaesthetic, with bradycardia and a fall in blood pressure. This is likely vasovagal syncope. Lay the patient flat, raise the legs, check the airway, give oxygen and monitor. If recovery is incomplete or the picture suggests anaphylaxis, call 999 and give intramuscular adrenaline according to the emergency protocol.
Traps that cost marks
Sitting a syncopal patient upright; delaying adrenaline in anaphylaxis; failing to check the emergency kit; sedating an unwell or unsupported patient; discharging a sedated patient without an escort; not recording observations and recovery.