Medical Emergencies
in Dental Practice –
Practice Standard
December 2016
,Contents
Purpose 2
Interpretation of requirements 3
Practitioners’ legal and ethical responsibility 4
Preparation for medical emergencies 4
Medical History 5
Resuscitation training 5
International training courses 7
Equipment 8
Drugs 8
Additional training, equipment and drugs required for dentists/ dental specialists administering sedation
(excluding RA) 9
Scheduling of appointments 9
Checklist 10
Appendix A – Medical emergency situations: specific responses 12
Anaphylaxis 12
Angina and myocardial infarction 14
Asthma 14
Choking and aspiration 15
Diabetes 15
Epilepsy 15
Faint (Syncope) 16
Hypoglycaemia 16
Hyperglycaemia 16
Hyperventilation 16
Appendix B – Quick Reaction Guide 18
Asthma 18
Cardiac conditions 19
Choking and aspiration 19
Epilepsy 19
Faint (Syncope) 20
Hypoglycaemia 20
Hyperventilation 20
This practice standard was last reviewed in September 2014. This version incorporates updates made in December
2016 to reflect the NZRC CORE course changes, and the new sedation practice standard resuscitation training
requirements approved in October 2016.
Medical Emergencies in Dental Practice – Practice Standard 2
, 1. Purpose
1.1. Oral health practitioners have a responsibility to put their patients’ interests first, and to protect
those interests by practising safely and providing good care. The practitioner’s ability to deal
with medical emergencies that arise in practice is a significant aspect of meeting their
responsibility to, and the expectations of, their patients.
1.2. Medical emergencies can and do occur in dental practice1. The early and effective
management of a medical emergency significantly improves the outcomes and reduces the
adverse effects of such an occurrence. Oral health practitioners need to have appropriate
skills, training and equipment available to deal with potentially life threatening conditions 2, 3.
1.3. The purpose of the Dental Council Medical Emergencies in Dental Practice - Practice Standard
(‘practice standard’) is to set the minimum standards for registered oral health practitioners for
the level of resuscitation training; the recertification intervals; and the equipment and drugs that
need to be available in the case of a medical emergency. The standards include
recommendations for implementation in the practice of dentistry, including subset scopes of
practice defined for oral health practitioners.
1.4. The minimum standard requirements in relation to equipment and drugs specified in the
practice standard apply in environments where scope of practice activities of a clinical nature
are undertaken by a registered oral health practitioner. These include preventive care and care
delivered at “off-site” facilities such as mobile units, domiciliary care or rest homes.
2. Interpretation of requirements
Must – A requirement expressed as “must” is a minimum standard that all oral health practitioners
must adhere to and comply with.
Should – A requirement expressed as “should” is a strong recommendation, but compliance will not be
monitored.
1
Broadbent, J.M., Thomson, W.M. The readiness of New Zealand General Dental Practitioners for Medical Emergencies. NZDJ 97: 82-
86; 2001.
2
Zacharias, M., Hunter, K.MacD. Cardiopulmonary Resuscitation in Dental Practice – an update. NZDJ 90: 60-65; 1994.
3
New Zealand Resuscitation Council. Basic Resuscitation 2002 Resuscitation 2000
Medical Emergencies in Dental Practice – Practice Standard 3
in Dental Practice –
Practice Standard
December 2016
,Contents
Purpose 2
Interpretation of requirements 3
Practitioners’ legal and ethical responsibility 4
Preparation for medical emergencies 4
Medical History 5
Resuscitation training 5
International training courses 7
Equipment 8
Drugs 8
Additional training, equipment and drugs required for dentists/ dental specialists administering sedation
(excluding RA) 9
Scheduling of appointments 9
Checklist 10
Appendix A – Medical emergency situations: specific responses 12
Anaphylaxis 12
Angina and myocardial infarction 14
Asthma 14
Choking and aspiration 15
Diabetes 15
Epilepsy 15
Faint (Syncope) 16
Hypoglycaemia 16
Hyperglycaemia 16
Hyperventilation 16
Appendix B – Quick Reaction Guide 18
Asthma 18
Cardiac conditions 19
Choking and aspiration 19
Epilepsy 19
Faint (Syncope) 20
Hypoglycaemia 20
Hyperventilation 20
This practice standard was last reviewed in September 2014. This version incorporates updates made in December
2016 to reflect the NZRC CORE course changes, and the new sedation practice standard resuscitation training
requirements approved in October 2016.
Medical Emergencies in Dental Practice – Practice Standard 2
, 1. Purpose
1.1. Oral health practitioners have a responsibility to put their patients’ interests first, and to protect
those interests by practising safely and providing good care. The practitioner’s ability to deal
with medical emergencies that arise in practice is a significant aspect of meeting their
responsibility to, and the expectations of, their patients.
1.2. Medical emergencies can and do occur in dental practice1. The early and effective
management of a medical emergency significantly improves the outcomes and reduces the
adverse effects of such an occurrence. Oral health practitioners need to have appropriate
skills, training and equipment available to deal with potentially life threatening conditions 2, 3.
1.3. The purpose of the Dental Council Medical Emergencies in Dental Practice - Practice Standard
(‘practice standard’) is to set the minimum standards for registered oral health practitioners for
the level of resuscitation training; the recertification intervals; and the equipment and drugs that
need to be available in the case of a medical emergency. The standards include
recommendations for implementation in the practice of dentistry, including subset scopes of
practice defined for oral health practitioners.
1.4. The minimum standard requirements in relation to equipment and drugs specified in the
practice standard apply in environments where scope of practice activities of a clinical nature
are undertaken by a registered oral health practitioner. These include preventive care and care
delivered at “off-site” facilities such as mobile units, domiciliary care or rest homes.
2. Interpretation of requirements
Must – A requirement expressed as “must” is a minimum standard that all oral health practitioners
must adhere to and comply with.
Should – A requirement expressed as “should” is a strong recommendation, but compliance will not be
monitored.
1
Broadbent, J.M., Thomson, W.M. The readiness of New Zealand General Dental Practitioners for Medical Emergencies. NZDJ 97: 82-
86; 2001.
2
Zacharias, M., Hunter, K.MacD. Cardiopulmonary Resuscitation in Dental Practice – an update. NZDJ 90: 60-65; 1994.
3
New Zealand Resuscitation Council. Basic Resuscitation 2002 Resuscitation 2000
Medical Emergencies in Dental Practice – Practice Standard 3
