Medical Emergencies and Infection Control
What the exam tests
This domain tests recognition and immediate management of office emergencies and compliance with infection prevention. The exam expects a structured response, correct drug and dose, and knowledge of sterilization monitoring.
Core rules and concepts
- Syncope: most common emergency; lay the patient supine, elevate legs, ensure airway and give oxygen if needed. Do not give epinephrine for simple vasovagal syncope.
- Hypoglycemia: give oral glucose if conscious; glucagon or IV glucose if not. Asthma: sit upright, give a bronchodilator, oxygen and escalate. Anaphylaxis: give intramuscular epinephrine 0.3 mg (0.5 mg in some protocols) into the anterolateral thigh and call emergency services.
- Chest pain: stop treatment, sit the patient upright, give oxygen and aspirin if not contraindicated, and activate emergency services.
- BLS: start compressions and use an AED as soon as available; do not delay calling for help.
- Infection control: perform hand hygiene, use PPE, avoid recapping needles and dispose of sharps immediately. Sterilize instruments by autoclave at 134°C for about 3 minutes or 121°C for about 15 minutes, with biological and chemical monitoring.
- Needlestick: wash, report, assess source and start post-exposure prophylaxis according to protocol; hepatitis B vaccination is preventive.
Worked example
A patient becomes pale and clammy immediately after an inferior alveolar injection. Reasoning: consider vasovagal syncope first, but also local anesthetic toxicity or anaphylaxis. Lay the patient supine, check airway and vital signs, give oxygen and monitor; if urticaria, wheeze or hypotension develop, give IM epinephrine and call emergency services.
Traps
Giving epinephrine for simple syncope; failing to activate emergency services early; recapping needles; skipping biological autoclave monitoring; treating anaphylaxis with antihistamine before epinephrine.