ADEX Managing Medical Emergencies 2 — Questions and Answers
Question 1: A patient suddenly becomes pale, diaphoretic, and reports feeling faint during scaling. What is the most likely emergency?
- Anaphylaxis
- Vasovagal syncope (Correct answer)
- Acute myocardial infarction
- Hypoglycemia
Correct answer: Vasovagal syncope
Vasovagal syncope (fainting) classically presents with pallor, diaphoresis, and pre-syncope triggered by anxiety or pain during dental procedures.
Question 2: What is the correct compression-to-ventilation ratio when performing adult CPR with two rescuers?
- 15:2
- 30:2 (Correct answer)
- 15:1
- 30:1
Correct answer: 30:2
The AHA recommends a 30:2 compression-to-ventilation ratio for adult CPR regardless of whether one or two rescuers are present.
Question 3: A patient with a known peanut allergy develops generalized urticaria and throat tightness five minutes after receiving a topical anesthetic. Which drug should be administered first?
- Diphenhydramine (Benadryl) IM
- Hydrocortisone IV
- Epinephrine 1:1000 IM (Correct answer)
- Albuterol inhaler
Correct answer: Epinephrine 1:1000 IM
Epinephrine 1:1000 administered IM into the mid-outer thigh is the first-line treatment for anaphylaxis because it reverses airway obstruction and hypotension rapidly.
Question 4: During a procedure, a patient with a history of epilepsy experiences a generalized tonic-clonic seizure. What is the dental hygienist's FIRST action?
- Insert a padded tongue depressor to protect the airway
- Clear the area of sharp objects and protect the patient from injury (Correct answer)
- Administer oxygen via nasal cannula at 2 L/min
- Call 911 immediately
Correct answer: Clear the area of sharp objects and protect the patient from injury
The priority is to prevent injury by moving sharp instruments away and cushioning the patient's head — never restrain the patient or place anything in the mouth.
Question 5: Which sign differentiates a hypoglycemic episode from a hyperglycemic one in a diabetic dental patient?
- Fruity breath odor
- Rapid onset of symptoms (Correct answer)
- Polyuria and polydipsia
- Flushed, dry skin
Correct answer: Rapid onset of symptoms
Hypoglycemia has a rapid onset (minutes to hours), while hyperglycemia develops slowly over hours to days; fruity breath and dry flushed skin indicate hyperglycemia.
Question 6: A patient complains of sudden severe chest pain radiating to the left arm. After activating EMS, the dental hygienist should:
- Have the patient lie flat in the supine position
- Administer one sublingual nitroglycerin tablet regardless of history
- Place the patient in a semi-reclined position and administer oxygen (Correct answer)
- Begin CPR immediately
Correct answer: Place the patient in a semi-reclined position and administer oxygen
A semi-reclined (45°) position reduces cardiac workload, and supplemental oxygen is appropriate while awaiting EMS for a suspected myocardial infarction.
Question 7: The epinephrine auto-injector (EpiPen) used for anaphylaxis in the dental office contains which concentration of epinephrine?
- 1:10,000
- 1:1,000 (Correct answer)
- 1:100,000
- 1:100
Correct answer: 1:1,000
The standard EpiPen delivers epinephrine at 1:1,000 concentration (1 mg/mL) in a 0.3 mg dose for adults.
ADEX Managing Medical Emergencies 2
A patient suddenly becomes pale, diaphoretic, and reports feeling faint during scaling.
What is the most likely emergency?