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Emergency dental kits for hospitals
Emergency dental kits for hospitals
Henry Heimansohn, DDS, Danville, Ind.
In most smaller hospitals, dental facilities are not available because of cost, infrequent need for dental treatment, lack of space, or the medical personnel's lack of fam iliarity with dental problems. Suggestions are made for an inexpensive dental kit for emergency use, which should be available in all hospitals.
This article concerns dental emergency treatment in an average small hospital. Such treatment is usually necessary after automobile accidents. A report of a case and suggestions for an emer gency dental kit that might be placed in all hos pitals without such facilities are presented. Most smaller hospitals have limited or no den tal facilities because of cost, lack of familiarity of medical personnel with dental problems, lack of room, infrequent need for dental treatment, and so forth. The dentists and oral surgeons bring their own instruments and use available hospital instruments. Most smaller hospitals do not have interns or residents. Therefore, a staff physician usually examines an emergency accident patient. Statis
tics indicate that 70 percent of automobile acci dent victims have facial injuries.1 Also, 40 percent of automobile accidents occur on weekends.2 The attending physician is usually hindered because most accident victims are unable to give a complete medical history. The patient is usu ally disoriented and it is not possible to obtain a history of heart disease, drug allergies, and so forth. The dental treatment necessary may or may not be extensive. Usually a dental X-ray unit is not available, and dental radiographs are taken with a medical X-ray machine. If a suitable dental emergency kit is available in the hospital, the dentist can provide immediate treatment without returning to his office for sup plies. Usually medical supplies are not adaptable to emergency dental treatment. Report of case An automobile accident occurred near the Hend ricks County Hospital, Danville, Ind., and the patient was brought to the emergency room. The patient was a 50-year-old man whose truck was struck from behind by a pickup truck. He had a fracture of the left humerus, a fracture of the anterior portion of the maxillary alveolar ridge, and lacerations of the scalp. The injured arm caused the patient acute dis tress. I was called to the emergency room for 1259
Suggested contents o f em ergency d e ntal k it fo r h o sp itals: d e ntal syringe ( 1 ) , arch b a r ( 2 ) , rubber bands fo r arch b a r ( 3 ) , w ire cutters ( 4 ) , lig a tu re w ire ( 5 ) , and hem ostats ( 6 ) . Bar c u tte r is n o t shown
consultation. The orthopedic surgeon had been called from Indianapolis. After examination of the patient and the radiographs, an upper arch bar was placed since the fractured segment of the maxilla was not displaced. I returned to my office to get a prosthetic 0.5 round bar, bar benders, wire cutters, ligature wire, dental syringe, and anesthetic. Returning to the hospital, I used local anes thesia and placed the upper arch bar. I thought there would be less trauma to the patient to place the bar while he was under local infiltration anesthesia rather than to work with the ortho pedic surgeon while the patient was under a gen eral anesthetic. The orthopedic surgeon agreed to this arrangement. Because the arch bar was stiff, however, it was not easy to make it conform to the arch.
The kit I contacted the hospital administrator and in quired whether a suitable dental emergency kit might be installed in the emergency room. The administrator agreed with the idea, and I made a tentative list of items that might be incorporated into such a kit. The administrator purchased these items. The original dental emergency kit consisted of these items: dental syringe, anesthetic, arch bar, wire cutters, ligature wire, sterile disposable 1 260 ■ J A D A , V o l. 7 4 , M a y
1967
needles, hemostat, and rubber bands (illustra tion). The composition of this kit may be changed at any time, and many dentists may prefer to use other items. Almost all hospitals have emergency medical facilities but few hospitals have emergency dental facilities. A small dental emergency kit is inex pensive. Dentists could donate such a kit to their local hospital. Role of general practitioner The general practitioner should not assume the duties of the oral surgeon for many reasons, in cluding legal considerations. The general prac titioner could, however, place Barton’s bandages, take dental radiographs, band or wire loosened individual teeth, control bleeding, help ascertain the extent of injuries to dental structures and, in general, give advice on dental matters. Standard nomenclature should be adapted for fractures, and more instruction should be given in the treatment of traumatic injuries to facilitate the duties of the general practitioner. D octor Heim ansohn's address is 4 W e st M a in , D an v ille , Ind. 4 6 1 2 2 . 1. D ingm an, R. O., and N a tvig , Paul. Surgery o f fa c ia l fractu re s. Philadelphia, W . B. Saunders Co., 1964. 2. A tragedy o f errors. In T he T ravelers 1 965 book o f street and highw ay a ccid e n t da ta. H a rtfo rd , Conn., p. 27.
Henry Heimansohn, DDS, Danville, Ind.
In most smaller hospitals, dental facilities are not available because of cost, infrequent need for dental treatment, lack of space, or the medical personnel's lack of fam iliarity with dental problems. Suggestions are made for an inexpensive dental kit for emergency use, which should be available in all hospitals.
This article concerns dental emergency treatment in an average small hospital. Such treatment is usually necessary after automobile accidents. A report of a case and suggestions for an emer gency dental kit that might be placed in all hos pitals without such facilities are presented. Most smaller hospitals have limited or no den tal facilities because of cost, lack of familiarity of medical personnel with dental problems, lack of room, infrequent need for dental treatment, and so forth. The dentists and oral surgeons bring their own instruments and use available hospital instruments. Most smaller hospitals do not have interns or residents. Therefore, a staff physician usually examines an emergency accident patient. Statis
tics indicate that 70 percent of automobile acci dent victims have facial injuries.1 Also, 40 percent of automobile accidents occur on weekends.2 The attending physician is usually hindered because most accident victims are unable to give a complete medical history. The patient is usu ally disoriented and it is not possible to obtain a history of heart disease, drug allergies, and so forth. The dental treatment necessary may or may not be extensive. Usually a dental X-ray unit is not available, and dental radiographs are taken with a medical X-ray machine. If a suitable dental emergency kit is available in the hospital, the dentist can provide immediate treatment without returning to his office for sup plies. Usually medical supplies are not adaptable to emergency dental treatment. Report of case An automobile accident occurred near the Hend ricks County Hospital, Danville, Ind., and the patient was brought to the emergency room. The patient was a 50-year-old man whose truck was struck from behind by a pickup truck. He had a fracture of the left humerus, a fracture of the anterior portion of the maxillary alveolar ridge, and lacerations of the scalp. The injured arm caused the patient acute dis tress. I was called to the emergency room for 1259
Suggested contents o f em ergency d e ntal k it fo r h o sp itals: d e ntal syringe ( 1 ) , arch b a r ( 2 ) , rubber bands fo r arch b a r ( 3 ) , w ire cutters ( 4 ) , lig a tu re w ire ( 5 ) , and hem ostats ( 6 ) . Bar c u tte r is n o t shown
consultation. The orthopedic surgeon had been called from Indianapolis. After examination of the patient and the radiographs, an upper arch bar was placed since the fractured segment of the maxilla was not displaced. I returned to my office to get a prosthetic 0.5 round bar, bar benders, wire cutters, ligature wire, dental syringe, and anesthetic. Returning to the hospital, I used local anes thesia and placed the upper arch bar. I thought there would be less trauma to the patient to place the bar while he was under local infiltration anesthesia rather than to work with the ortho pedic surgeon while the patient was under a gen eral anesthetic. The orthopedic surgeon agreed to this arrangement. Because the arch bar was stiff, however, it was not easy to make it conform to the arch.
The kit I contacted the hospital administrator and in quired whether a suitable dental emergency kit might be installed in the emergency room. The administrator agreed with the idea, and I made a tentative list of items that might be incorporated into such a kit. The administrator purchased these items. The original dental emergency kit consisted of these items: dental syringe, anesthetic, arch bar, wire cutters, ligature wire, sterile disposable 1 260 ■ J A D A , V o l. 7 4 , M a y
1967
needles, hemostat, and rubber bands (illustra tion). The composition of this kit may be changed at any time, and many dentists may prefer to use other items. Almost all hospitals have emergency medical facilities but few hospitals have emergency dental facilities. A small dental emergency kit is inex pensive. Dentists could donate such a kit to their local hospital. Role of general practitioner The general practitioner should not assume the duties of the oral surgeon for many reasons, in cluding legal considerations. The general prac titioner could, however, place Barton’s bandages, take dental radiographs, band or wire loosened individual teeth, control bleeding, help ascertain the extent of injuries to dental structures and, in general, give advice on dental matters. Standard nomenclature should be adapted for fractures, and more instruction should be given in the treatment of traumatic injuries to facilitate the duties of the general practitioner. D octor Heim ansohn's address is 4 W e st M a in , D an v ille , Ind. 4 6 1 2 2 . 1. D ingm an, R. O., and N a tvig , Paul. Surgery o f fa c ia l fractu re s. Philadelphia, W . B. Saunders Co., 1964. 2. A tragedy o f errors. In T he T ravelers 1 965 book o f street and highw ay a ccid e n t da ta. H a rtfo rd , Conn., p. 27.