Urgências e emergências médicas na odontologia: será que estamos preparados?

Abstract

The objective of the present study was to evaluate the preparation and self-perception for medical emergencies and urgencies among dental surgeons and dentistry students. This is a cross-sectional study based on the application of an online questionnaire that assessed preparation and experience; knowledge and self-perception. The selection of participants was based on convenience sampling. Data were analyzed using descriptive statistics, chi-square test and Fisher's exact test, considering a significant p-value <0.05. A total of 144 valid responses were obtained, 57.63% of the participants had access to some teaching or training in emergencies and medical urgencies during college. Evaluating the sample of students, it was observed that the proportion of students from the private network was 40% higher in terms of access to content than students from the public network. Only 29.86% sought training on the subject in some “workshop” or training course outside or after graduation. The offices in which the dentists worked were not sufficiently equipped to provide the first necessary care, 23.6% of the participants had already faced emergency situations and medical urgencies during clinical practice, with hypoglycemia being the most prevalent. A significant part obtains completed health history information (93.05%), asks about the previous history of allergies or medications (99.30%) and records vital signs before treatment (73.61%). Most participants were aware of epilepsy management (81.94%) and unconsciousness (70.83%). However, they needed more training for syncope (41.66%), airway obstructions (55.55%) and anxiety hyperventilation (52.77%). They had a good level of knowledge to diagnose cases of hypoglycemia (97.22%), anaphylaxis (90.27%) and ischemic angina pectoris (88.19%). On the other hand, three quarters of the participants did not know the drug treatment for angina pain, acute myocardial infarction and anaphylaxis and asthma. It was noted that the participants knew equipment such as the stethoscope (98.61%) and the sphygmomanometer (94.44%) and were unaware of portable suction device (84.02%), cricothyroidotomy puncture needle (72.9% ) and self-inflating mask (68.05%). In addition, they were more confident in using equipment they knew. Regarding self-perception, a small portion of the participants (6.95%) considered themselves capable of dealing with any emergency situation and medical urgency during dental care, 84.72% of the sample studied did not feel able to handle the initial management of sudden cardiac arrest, 84.02% of anaphylactic shock and 78.47% of angina. The correlation between knowledge and self-perception with the teaching network variable was analyzed, within the group of students, it was identified that students from the public network were better in questions about the management of anxiety hyperventilation and drug treatment of allergic reaction situations (p-value < 0.05). As for self-perception, students from the private network feel more confident to deal with any emergency situation and medical urgency (p-value=0.01). The time of professional practice did not differ in terms of these analyzes among dentists. It was concluded that both the offices and the dentists and students, who were part of the sample studied, are not fully prepared and confident to deal with emergencies and medical urgencies in clinical practice.