The preparedness of private dental offices and polyclinics for medical emergencies: A survey in Western Saudi Arabia

Objectives:

To assess preparedness for medical emergencies in private dental offices in Jeddah, Kingdom of Saudi Arabia (KSA).

Methods:

In this cross-sectional study, a survey was distributed to 70 dental offices and polyclinics in Jeddah, Saudi Arabia between October 2013 and January 2014. The questionnaire gathered information on the prevention of medical emergencies, the preparedness of the office personnel, and availability of emergency drugs and equipment.

Results:

For prevention, 92% (n=65) of the offices reported that they obtain a thorough medical history prior to treatment; however, only 11% (n=8) obtain vital signs for each visit. Using a preparedness percent score (0 to 100), the mean level of preparedness of the office personnel in all surveyed dental offices was 55.2±20. The availability of emergency drugs was 35±35, and equipment was 19±22.

Conclusion:

We found a deficiency in personnel training, availability of drugs, and emergency equipment in the surveyed dental clinics. More stringent rules and regulations for emergency preparedness must be reinforced to avoid disasters in these clinics.Although uncommon, medical emergencies can occur at anytime in the dental office, possibly posing a direct threat to the patient’s life, and hindering the delivery of dental care.1,2 The prevalence, and severity of medical emergencies has been reported in various dental settings (academic or private) in many countries.3-5 In one 10-year survey study in Great Britain, an emergency event was reported, on average occurring with an average frequency of between one in 3.6-4.5 practice years.6 In a study published in 2009, Wilson et al7 found that the most prevalent medical emergency reported by dentists over a 12 month period was syncope (1.9 cases per year), followed by angina and hypoglycemia (0.17 per year), and epileptic fit (0.13 cases per year).7 Preparedness for acute medical emergencies in the dental office begins with a team approach by the dentist and staff members who have up-to date certification in basic life support (BLS) for health care providers. It also includes dentist and personnel training through mock drills and continuing education courses, a medical emergency protocol, availability of an emergency drug kit, and proper emergency equipment.8,9 The preparedness of dental offices was addressed through questionnaires for studies from different countries where a general consensus was reached for the need for continuous training and more stringent guidelines for medical emergencies.7,10 In the Kingdom of Saudi Arabia (KSA), there is a reported high prevalence of diabetes, obesity, and hypertension,11-13 all of which may contribute to a higher occurrence of medical emergencies in the dental office. A current literature search using the Medline and PubMed databases (from 1990-2014), revealed that there is a scarcity of published data on the prevalence, types, or severity of medical emergency events in government dental clinics, dental schools, or private dental practice. Additionally, no data could be found assessing the preparedness of private dental offices for medical emergencies in KSA. The Ministry of Health (MOH) in KSA oversees the licensing and operation of private dental clinics and polyclinics. It does not mandate that private dental offices have a specific emergency protocol, emergency drugs, or equipment. The objective of our study was to assess the preparedness and training of the office personnel, and availability of emergency drugs, and emergency equipment in a sample of private dental practices and polyclinics in Jeddah, KSA.