11/26/2013

Emergency kit basics for dental practices


What must a dental office emergency kit contain? The answer varies depending on individual state dental board requirements. There are basic necessities dentists are required to include in emergency kits, according to the American Dental Association Council on Scientific Affairs.

Some states may have more rigorous emergency kit requirements, and The Dentists Insurance Company advises dentists to check with their state dental board or dental association for specifics on what to include beyond ADA recommendations. Practices administering oral conscious sedation are required to meet additional emergency standards, as outlined by state dental boards.

Further, the Occupational Safety and Health Administration (OSHA) requires emergency supplies to be available in case of an employee injury. TDIC advises dentists to maintain separate emergency kits for employees and patients.

Practitioners can assemble emergency kits themselves or purchase them already assembled. Commercial emergency drug kits for dentistry can provide consistent drug availability along with a service to update drugs on a regular basis. Dentists must document that all emergency equipment and drug expiration dates are checked on a regularly scheduled basis.

TDIC advises all dentists to know when, how and in what dosages to administer drugs included in their emergency kits. Stocking emergency medications but lacking the training to administer them appropriately can be a liability. Best practice calls for continuing education in emergency protocol for dentists, for the office to be prepared with an established emergency plan and a team approach by the dentist and staff who are certified in basic life support. TDIC outlines dental office emergency protocol in its Risk Management Reference Guide, which is available online at thedentists.com.

The ADA Council on Scientific Affairs, in its 2002 report in the Journal of the American Dental Association, “Office Emergencies and Emergency Kits,” recommends the following drugs be included as a minimum. This essential list remains the standard:

  • Epinephrine 1:1,000 (injectable)
  • Histamine-blocker (injectable)
  • Oxygen with positive-pressure administration capability
  • Nitroglycerin (sublingual tablet or aerosol spray; be aware of contraindications)
  • Bronchodilator (asthma inhaler)
  • Sugar (a quick source of glucose such as orange juice)
  • Aspirin

Additional items to include in a patient emergency kit:

  • Aromatic ammonia
  • Blood pressure monitoring equipment
  • CPR pocket mask
  • Syringes
  • Tourniquets
  • High-volume suction and aspiration tips or tonsillar suction

OSHA requires employers to have emergency kits for employees and lists the following supplies as adequate for small work sites, consisting of approximately two to three employees. Larger practices should provide additional supplies or emergency kits. While federal law does not require that a physician approve emergency kits, some states such as California do require physician sign off. Here are OSHA’s recommendations:

  • Directions for requesting emergency assistance
  • Gauze pads (at least 4 x 4 inches)
  • Two large gauze pads (at least 8 x 10 inches)
  • One box of adhesive bandages
  • One package gauze roller bandage (at least 2 inches wide)
  • Two triangular bandages
  • Wound cleaning agent (such as sealed moistened towelettes)
  • Scissors
  • At least one blanket
  • Tweezers
  • Adhesive tape
  • Latex gloves
  • Resuscitation equipment (such as resuscitation bag, airway or pocket mask)
  • Two elastic wraps
  • Splint

For more information or if you have questions regarding this topic, contact the TDIC Risk Management Advice Line at 800.733.0634.