Medical Emergency Protocols
Step-by-step management for 12 medical emergencies in dental practice. Aligned with Resuscitation Council UK (RCUK, including anaphylaxis 2021), AHA BLS where noted, and Indian EMS practice (108 / 112).
Last reviewed October 2026 · D4Dent Clinical Editorial Review
Select a condition
Tap a card to open the chair-side protocol below.
Choose a condition above to view recognition signs, steps, and doses.
Universal chair-side rules
- 1Stop treatment immediately; remove instruments from the mouth.
- 2Assess responsiveness, airway, breathing, and circulation (ABC).
- 3Call for help early — shout; assign a named person to dial 108/112.
- 4Fetch the emergency kit and AED; note the time of onset.
- 5Give oxygen when indicated (high-flow face mask 10–15 L/min if available).
- 6Do not leave the patient alone; stay until recovery or handover to EMS.
- 7Document drugs, times, and response; debrief the team after every event.
2-chair clinic role card
Dentist (Chair lead)
- • Stay with the patient; manage airway and first-line drugs
- • Direct the team and decide when to call EMS
- • Handover to paramedics with times and doses given
Dental assistant
- • Bring emergency kit, oxygen, and AED
- • Prepare adrenaline / inhaler / glucose as directed
- • Assist with positioning, monitoring, and CPR switch
Reception / second chair cover
- • Call 108/112 using the call script; unlock clinic entrance
- • Clear corridor for stretcher; guide EMS to the chair
- • Calm other patients; pause the second chair if needed
108 / 112 call script
- I am calling from a dental clinic. We have a medical emergency.
- Clinic name and full address (landmarks if useful).
- Patient: age, sex, conscious or not, breathing or not.
- Suspected problem (e.g. anaphylaxis, chest pain, cardiac arrest, seizure).
- What we have already done (adrenaline, CPR, aspirin, oxygen).
- Best phone number and entrance instructions for the ambulance.
- Stay on the line until the dispatcher says you may hang up.
Chair position quick table
| Situation | Position | Note |
|---|---|---|
| Vasovagal syncope / hypotension | Supine, legs elevated 10–15° | Do not sit upright until fully recovered |
| Anaphylaxis with hypotension | Supine, legs elevated (if breathing allows) | If marked dyspnoea, allow sitting; avoid standing |
| Asthma / breathlessness | Upright / sitting forward | Do not lay flat |
| Cardiac arrest / CPR | Chair fully flat and locked, or transfer to floor | Hard surface required; firm chair back can work if fully flat |
| Seizure (post-ictal) / unconscious airway | Recovery position (lateral) when safe | Protect head during active seizure; clear area |
| Chest pain / suspected MI (conscious) | Semi-upright, comfortable | Loosen clothing; do not force flat if breathless |
| Choking (conscious) | Upright; lean forward for back blows | Follow choking algorithm; do not finger-sweep blindly |
Emergency kit checklist
Prioritise Must items first. Quantities and warnings reflect common dental-kit guidance — adapt to your state rules and medical director.
Must
Adrenaline 1:1000 (1 mg/mL)
3–5 ampoules + 1 mL syringes and IM needles
⚠ Age-band doses; check expiry monthly
Aspirin
300 mg dispersible tablets (for suspected MI)
⚠ 75 mg alone is the wrong strength for acute chest pain dosing
Salbutamol MDI + spacer
100 mcg/puff inhaler with adult/child spacer
Glucose
Tablets/gel 15–20 g + glucometer + strips
GTN (glyceryl trinitrate) spray
Sublingual spray for chest pain (if not contraindicated)
Oxygen + delivery
Cylinder/regulator or concentrator + face mask
⚠ Pocket/small O₂ cans may last under 1 minute at 10–15 L/min — not a substitute for a proper cylinder
AED
Automated external defibrillator with adult pads (child pads if treating children)
Basic airway kit
Pocket mask or BVM, oropharyngeal airways (sized), suction
Should
Glucagon
1 mg IM kit for unconscious hypoglycaemia
Midazolam (buccal) — if legally held
Age-banded buccolingual doses for prolonged seizures
⚠ Controlled drug in India — store and prescribe per NDPS / state rules
Hydrocortisone injection
For adrenal crisis / hospital-directed severe asthma
⚠ Not routine first-line for anaphylaxis (RCUK 2021)
Pulse oximeter + BP cuff
Spot SpO₂ and blood-pressure monitoring
IV access set + crystalloid
For trained staff: fluid bolus in anaphylaxis / shock
Optional
Chlorpheniramine injection
Antihistamine after adrenaline only in anaphylaxis
Rectal diazepam
Alternative seizure drug if buccal midazolam unavailable
Bag-valve-mask (sizes)
Preferred ventilation if trained
Monthly check
Monthly kit check: expiry dates, ampoule counts, AED self-test, oxygen level, glucometer strips, seal intact.
Six-monthly drill
Six-monthly team drill: run one scenario (e.g. anaphylaxis or arrest), time the call to 108/112, and refresh role card assignments.
Disclaimer & sources
Educational quick-reference only. Verify every dose against the current BNF (or equivalent), product label, and your clinic’s medical director. This page is not a substitute for certified BLS/ALS training or local protocols.
Last reviewed: October 2026 · Reviewer: D4Dent Clinical Editorial Review
- Resuscitation Council UK (RCUK) — anaphylaxis 2021; medical emergencies in the dental practice
- American Heart Association (AHA) Basic Life Support guidance where noted
- Indian Resuscitation Council / local EMS practice (108 / 112)
Keep emergency readiness part of practice culture
Print the wall chart, assign roles for your 2-chair team, and run a six-monthly drill. D4Dent helps clinics organise daily workflows so preparedness stays visible — not buried in a drawer.
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