Management of Pediatric Medical Emergencies in the Dental Office
Staff Training and Duties

All staff involved in direct patient care should receive training in recognition of emergency situations and Basic Life Support (BLS). A receptionist at the front desk will be the one most likely to be alerted to an emergency in the waiting area. All staff should be familiar with the location of the emergency drug kit, monitoring and resuscitation equipment as well as Emergency Medical Services (EMS). For greater efficiency, each staff member should be assigned a predefined role during an emergency. Periodically these roles should be reassigned to other personnel, so staff is familiar with all aspects of emergency management. An efficient emergency team can be organized with as few as two or three staff. In offices where sedation and general anesthesia is administered, training in PALS or ACLS is recommended for the Dentist and in some states, this is required for the clinical staff. A suggested assignment of duties follows:

Team member #1 is the first person on the scene when the emergency occurs. Thus, every staff member should be familiar with the Team Member #1 duties since an emergency can occur in any location within the office. After the initial activation of the emergency team, a team with advanced training can assume the role of Team Member #1. Upon discovery of an emergency patient:

Team member #1 duties include:

• Alerting other office staff members.
• Activating BLS (Positioning, Circulation, Airway maintenance, Breathing, Definitive treatment) after assessing the victim’s responsiveness.
• Staying with the victim.

Team member #2 duties include:

• Retrieval of the emergency drug kit, Oxygen cylinder, monitoring equipment and automated electronic defibrillator (AED) to the emergency site.
• Assist with BLS.
• Contact EMS, if deemed necessary and there is no other team member available.
• Check the level of Oxygen in the cylinder daily.
• Check the emergency kit weekly.
• Check the AED and monitoring equipment weekly.

Team member #3 duties include:

• Assist with BLS.
• Consult with family accompanying patient as to previous history and management of emergency.
• Contact EMS, if deemed necessary.
• Monitor vital signs.
• Prepare emergency drugs for administration.
• Meet the rescue team at the building entrance and escort them to the office.