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Emergências médicas em medicina dentária: prevalência e experiência dos médicos dentistas em Portugal
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Introdução: As emergências médicas em medicina dentária podem representar risco para a vida ou estado de saúde do doente. A resposta por parte dos médicos dentistas deve ser, por isso, rápida e eficaz, adequando-se a cada situação clínica.
Objetivos: Determinar a prevalência das emergências médicas no âmbito da consulta de medicina dentária em Portugal, aferir a formação e competência dos médicos dentistas, bem como descrever os fármacos e equipamentos disponíveis nos consultórios dentários.
Materiais e métodos: Os dados foram recolhidos através de um inquérito online entre os meses de março e agosto de 2020, de carácter voluntário e confidencial. Foi aplicada estatística descritiva e analítica.
Resultados: Foram considerados 176 questionários. 70% da amostra contactou com emergências médicas durante a consulta de medicina dentária. A síncope vasovagal foi a emergência mais prevalente (56%), seguida das crises de hipo e hiperglicemia, da hiperventilação e dos estados convulsivos. O enfarte do miocárdio e o AVC foram relatados por 2 médicos dentistas, enquanto que a paragem cardiorrespiratória foi assinalada por 1. 76% revelou ter formação em emergências médicas, sendo que, 89% e 84% se sente capaz de realizar SBV e a medição dos sinais vitais, respetivamente. Estabeleceu-se uma relação estatisticamente significativa entre ter formação e saber realizar alguns procedimentos técnicos. O ambu, o estetoscópio e o esfigmomanómetro estão presentes em aproximadamente metade das clínicas, assim como os fármacos simpaticomiméticos, antiagregantes plaquetários e o oxigénio.
Discussão: A maioria das variáveis está de acordo com a literatura e com os estudos semelhantes anteriormente realizados.
Conclusões: As emergências médicas nos consultórios de medicina dentária são frequentes, no entanto, as situações emergentes que representam ameaças para a vida e saúde dos doentes são pouco comuns. É importante que a formação prática constitua parte do ensino pré-graduado e que os consultórios dentários disponham de um conjunto de fármacos e equipamentos indispensáveis para responder às situações de emergência médica.
Introduction: Medical emergencies in dental appointments can represent a risk to the patient's life or health. The physician’s response must be fast and assertive. Objectives: To determine the prevalence of medical emergencies taking place in dental appointments in Portugal, to measure the training and competence of dentists, and to describe the drugs/equipment available in the dental office. Materials and methods: Data was collected through an online form between March and August of 2020, on a voluntary and anonymous basis. Descriptive statistics and analytical statistics were applied. Results: 176 forms were valid and therefore taken into account. 70% of the sample has already faced medical emergencies during the dental appointment. Vasovagal syncope was the most prevalent emergency (56%), followed by hypo/hyperglycemia, hyperventilation and seizures. Myocardial infarction and stroke were reported by 2 dentists and cardiorespiratory arrest was reported by 1. Most of them revealed to have training related to medical emergencies (76%), with 89% and 84% feeling able to perform BLS and assess vital signs, respectively. A relation was established between having training and performing some technical procedures. Ambu, stethoscope and sphygmomanometer are present in approximately a half of the clinics, as well as sympathomimetic drugs, antiplatelet agents and oxygen. Discussion: Most variables are in accordance with the literature and similar studies. Conclusions: Medical emergencies in dental practices are frequent, however, the situations that most threaten the life and health of patients are not very prevalent. It is important that practical training is part of undergraduate education and that the recommendations on drugs and equipment that should be included in the dental office are reviewed.
Introduction: Medical emergencies in dental appointments can represent a risk to the patient's life or health. The physician’s response must be fast and assertive. Objectives: To determine the prevalence of medical emergencies taking place in dental appointments in Portugal, to measure the training and competence of dentists, and to describe the drugs/equipment available in the dental office. Materials and methods: Data was collected through an online form between March and August of 2020, on a voluntary and anonymous basis. Descriptive statistics and analytical statistics were applied. Results: 176 forms were valid and therefore taken into account. 70% of the sample has already faced medical emergencies during the dental appointment. Vasovagal syncope was the most prevalent emergency (56%), followed by hypo/hyperglycemia, hyperventilation and seizures. Myocardial infarction and stroke were reported by 2 dentists and cardiorespiratory arrest was reported by 1. Most of them revealed to have training related to medical emergencies (76%), with 89% and 84% feeling able to perform BLS and assess vital signs, respectively. A relation was established between having training and performing some technical procedures. Ambu, stethoscope and sphygmomanometer are present in approximately a half of the clinics, as well as sympathomimetic drugs, antiplatelet agents and oxygen. Discussion: Most variables are in accordance with the literature and similar studies. Conclusions: Medical emergencies in dental practices are frequent, however, the situations that most threaten the life and health of patients are not very prevalent. It is important that practical training is part of undergraduate education and that the recommendations on drugs and equipment that should be included in the dental office are reviewed.
Descrição
Tese de mestrado, Medicina Dentaria, Universidade de Lisboa, Faculdade de Medicina Dentaria, 2020
Palavras-chave
Saúde Oral Teses de mestrado - 2020