Medical Emergencies · patient case question
Which is the MOST common medical emergency in the dental office?
Patient case: Type 1 diabetic who skipped breakfast
Patient: Male, 31 years old
Chief Complaint: Attends a morning appointment for a restoration.
Background: Type 1 diabetes on a basal-bolus insulin regimen. He took his usual morning insulin but forgot to eat breakfast before leaving the house.
Current Findings: Twenty minutes into the appointment he becomes pale, sweaty and shaky, and reports feeling dizzy and confused. He is conscious and able to swallow.
Vital Signs: BP 118/72 mmHg · HR 104 bpm · Respirations 18/min
Show answer and explanation
Correct answer: B. Syncope
- A. Anaphylaxis is dramatic and life-threatening but rare in dental practice.
- B. CORRECT. Vasovagal syncope accounts for roughly half of all medical emergencies in dental practice. Anxiety, pain, the sight of a needle or a prolonged upright posture trigger a vagal surge with bradycardia and vasodilation, cerebral hypoperfusion follows, and the patient faints. Management is positional — supine with the legs elevated — plus airway, oxygen and reassurance.
- C. Myocardial infarction occurs but is far less frequent than syncope.
- D. Seizures occur mainly in patients with known epilepsy and are much less common than syncope overall.
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