RISK
Estimate of Disease 2008
 Cardiovascular Disease
4,212,800
 Asthma
2,049,700
 Hypertension
1,945,800
 Diabetes
818,200
 Epilepsy
138,800
 Allergy - undefined
1,029,500
© ABS National Health Survey Summary Results 2009
Death from Disease - 2010
Most Common Cause of Death in Australia 2010
© Australian Bureau of Statistics
45,000
41,952
40,000
34,886
35,000
30,000
25,000
20,000
15,000
11,220
11,049
Cerebrovascular
Respiratory
10,000
5,000
0
Neoplasms
Circulatory
Death from Non - Disease
Causes - 2010
Non-Medical Causes of Death Australia 2010
© Australian Bureau of Statistics
2,500
2,366
2,000
1,601
1,501
1,500
1,370
1,000
500
0
Poisoning
Suicide
Transport Accidents
Falls
Death from Disease - 2010
Medical Causes of Death Australia 2010
© Australian Bureau of Statistics
25,000
22,523
20,000
15,000
10,000
4,170
5,000
1,796
1,188
0
Ischaemic Heart Disease
Diabetes Mellitus
Influenza and Pneumonia
Aortic Aneurysm
Death in Care 2010
Deaths Relevant to Medical and Surgical Practice
Australia 2010
- 556 people
© Australian Bureau of Statistics
250
196
200
141
150
124
100
50
0
Medical Care
Result of Surgical or other Procedure
Inhalation of gastric contents or
Airway Obstruction
Presenting Problems
 Sudden Collapse
 Poor Perfusion (Shock)
 Altered conscious state
 Cardiac Chest Pain
Causes of Sudden Collapse
Two Main Causes
 Most Common
 Fainting
 Most Dangerous
 Cardiac
Arrest
Comparison
Faint
Cardiac Arrest
Altered Consciousness
Altered Consciousness
Pale, Cold, Wet Skin
Pale, Cold, Wet Skin
No Pulse
No Pulse
Altered Respiration
Altered Respiration
Treatment
Lay patient flat
 Check:
 Faints
Response, Airway, Breathing
recover, cardiac arrest worsens
Immediately start chest compressions
Raise alarm
Get and use Semi Automatic Defibrillator
Insert LMA and begin IPPV
Causes of Poor Perfusion
 Failure of the heart as a pump - Cardiac
 Failure of circulatory system - fainting
 Fluid loss – absolute or relative
 Blood,
Plasma, Water
 Septicaemia
 Anaphylaxis
Diagnosing Poor Perfusion
Two of four indicators present:
Conscious
Skin
State is altered
is pale, cold and wet
Respirations
 25
a minute or faster
 10
a minute or slower
Pulse
 100
 50
a minute or faster
a minute or slower
Treatment
 Posture patient flat or for comfort
 Oxygen at 8 litres per minute
 Take observations and record ASAP
 Call Ambulance
 Prepare to manage unconsciousness
Chest Pain
All chest pain is life
threatening until you
PROVE it is not!
Cardiac Chest Pain
 Pattern
 Half
way between up the chest
 Radiating
 May
to left neck, jaw or arm
radiate to right neck, jaw or arm
 Descriptive Words;
 heavy,
crushing, tight or dull ache
 Uses broad hand gestures
 Can’t
put their finger on it
Cardiac Chest Pain
All chest pain is life
threatening till you
PROVE it is not!
Almost 14,000 will
die in the first 60
minutes
Managing the Incident
Considerations
 What equipment do we have available
 Is
it labour saving
 Can
it provide definitive care
 S-AED,
Adrenaline, Salbutamol
 Training
 Individual
 Team
 Time
The Process
 Organise Equipment
 Practice the response
 Team effort
 Keep
the dentist free
 Identify
 Let
the presenting problem
the team do their job – Immediate Drill
 Get a provisional diagnosis but never withhold
treatment till you do.
Immediate Drill
 Automatic Response by team
 Identify
 Raise
alarm and
 Posture
 Get
problem,
patient
gear, all of it - Bag to nurse, booklet to dentist
 Oxygen
on and applied appropriately
 Purpose is to free dentist to make decisions
Deliberate Treatment
 Specific treatment for the presenting problem
or condition provisionally diagnosed by the
dentist.
 Taking and recording of observations
 Ensuring patient’s condition is being improved
or at least maintained by treatment
Cynergex Group Pty Ltd
Providing OHS First Aid Medical Equipment & Services
37/2 Chaplin Drive
Lane Cove NSW 2066
Phone: 02 9420 4699
Fax: 02 9420 4703
www.cynergexgroup.com.au