Patient Safety, Infection Control, Medical Emergencies and Medically Complex Patients
This domain tests systems that prevent harm and safe management of comorbid patients.
Core rules
- Standard precautions include hand hygiene, PPE, sharps safety, sterilization monitoring and waste segregation.
- Emergencies include syncope, hypoglycemia, angina, myocardial infarction, asthma, anaphylaxis, seizure, choking and adrenal crisis. Know drugs, doses and when to call emergency services.
- Medically complex patients include those on anticoagulants or antiplatelets, with diabetes, hypertension, pregnancy, immunosuppression or bisphosphonate therapy. Consult when needed.
- Medication-related osteonecrosis of the jaw is associated with IV bisphosphonates, denosumab and antiangiogenics. Avoid elective extractions when possible and minimize trauma.
- Consent, documentation, checklists and team training are safety tools.
Worked example
A patient on warfarin for atrial fibrillation needs extraction. Check INR; if within therapeutic range, proceed with local measures. Do not stop warfarin without cardiology advice. Use tranexamic mouthwash and suture.
Traps
Stopping anticoagulants routinely; giving epinephrine in true allergy; missing hypoglycemia; not having an emergency kit; ignoring sterilization monitoring.