Hospital Dentistry - Cardiology - Medically compromised patients

(Medically compromised) - with Dr.Qais

 

Hypotension

It can be happen due to:

1-      Anaphylactic shock

2-      Neurogenic shock

3-      Low fluid( severe diarrhea)

4-      Loss of blood 

5-      Cardiac pump failure (MI.Arrhthmias)

 

Management:

-put his head down and leg up. (supine)

-remove stimuli (stop treatment)

-ABC's

*always try to make your dental treatment atraumatic.

 

·         Some medicine like ca+2 blocker give some metallic taste in mouth + gingival hypertensions.

·         Aspirin is antiplateles + lavex ( aspirin and anti platelets.

·         Warfarin : anti coagulant.

Vasodepressor synocope

Common in dentistry
Causes: depressed cerebral blood flow

 

Clinical manifestation

Early: Nausea, Warmth, Perspiration, loss of color, Baseline Blood pressure, Tachycardia

Late: Hypotension, Bradycardia, Hyperpnea, Pupillary dilation, Peripheral coldness Peripheral coldness

Visual disturbance, Loss of consciousness

Management:

Place patient in supine position, while pregnant ladies on lateral decubitus.

Assess consciousness
Check ABC

Oxygen administration.

Diabetes Mellitus

Types:
Type 1 IDDM : little or no insulin is secreted uptake of glucose or conversion into glycogen in

the liver does not occur, therefore liver glucose production is elevated.

Type 2 NIIDM : Insulin resistance causes the liver to continue glucose production and prohibits glucose uptake by muscles

 

Problems with diabetic patient:

Hyperglycemia, Hypoglycemia, Infection – low immune system.

Diagnosis: take prober history

Our problem not with hyperglycemia but the real problem is hypoglycemia .

Hypoglycemia symptoms:
disorientation,
rapid pulse
and sweating.

If patient blood sugar isn't controlled, refer to his physician.
Routine dental treatment can be carried out,
but when it comes to surgeries or extractions, make sure to measure the blood suger of the patient.
If elevated, more than  200, you shouldn’t work, to prevent any possible complications.
Anastasia can be administered normally to diabetic patients.