Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (4): 342-349.doi: 10.24920/003708
• Original Article • Previous Articles Next Articles
Quan Jing, Kuo Wan(), Lin Ma, Jizhi Zhao
Received:
2020-01-05
Accepted:
2020-03-23
Published:
2020-12-31
Online:
2021-01-08
Contact:
Kuo Wan
E-mail:wankuo@126.com
Medical emergencies in dental clinics threaten patient safety and have gained increasing attentions. This survey on medical emergencies in dental clinics in China mainland is based on the largest sample of Chinese dentists and covers the broadest regions and dental specialties. The results provide important evidence for optimizing dental education. |
Quan Jing, Kuo Wan, Lin Ma, Jizhi Zhao. Medical Emergencies in Dental Clinics: A Survey of 2013 Dentists in China[J].Chinese Medical Sciences Journal, 2020, 35(4): 342-349.
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Table 1
Demographic characteristics of dentists participating in the survey (n=2013)"
Characteristics | Encountering medical emergencies | Sub-total | χ | P value | |
---|---|---|---|---|---|
No (n=303) | Yes (n=1710) | ||||
Gender [n(%)] | 0.27 | 0.60 | |||
Male | 172 (15.43) | 943 (84.57) | 1115 (55.39) | ||
Female | 131 (14.59) | 767 (85.41) | 898 (44.61) | ||
Age [years, n(%)] | 57.16 | <0.01 | |||
<30 | 133 (23.54) | 432 (76.46) | 565 (28.07) | ||
30-40 | 80 (14.44) | 474 (85.56) | 554 (27.52) | ||
41-50 | 76 (12.30) | 542 (87.70) | 618 (30.70) | ||
>50 | 14 (5.07) | 262 (94.93) | 276 (13.71) | ||
Practicing Region [n(%)] | 41.03 | 0.01 | |||
Beijing-Tianjin-Hebei | 90 (21.38) | 331 (78.62) | 421 (20.91) | ||
North China | 69 (12.00) | 506 (88.00) | 575 (28.56) | ||
East China | 91 (18.72) | 395 (81.28) | 486 (24.14) | ||
Northeast China | 23 (15.75) | 123 (84.25) | 146 (7.25) | ||
Central and South China | 20 (10.87) | 164 (89.13) | 184 (9.14) | ||
West China | 10 (4.98) | 191 (95.02) | 201 (9.99) | ||
Type of facility [n(%)] | 11.49 | 0.01 | |||
Outpatient department of dental school hospital | 83 (18.91) | 356 (81.09) | 439 (21.81) | ||
Private dental clinics or hospitals | 110 (13.35) | 714 (86.65) | 824 (40.93) | ||
Stomatological department in a general hospital | 93 (13.76) | 583 (86.24) | 676 (33.58) | ||
Other unspecified | 17 (22.97) | 57 (77.03) | 74 (3.68) | ||
Length of practice (years) | 19.43 | <0.01 | |||
<5 | 133 (23.54) | 432 (76.46) | 565 (28.07) | ||
5-10 | 80 (14.44) | 474 (85.56) | 554 (27.52) | ||
11-15 | 51 (12.78) | 348 (87.22) | 399 (19.82) | ||
16-20 | 25 (11.42) | 194 (88.58) | 219 (10.88) | ||
>20 | 14 (5.07) | 262 (94.93) | 276 (13.71) | ||
Number of specialties per dentist [n(%)] | 5.68 | 0.02 | |||
1 | 259 (15.99) | 1361 (84.01) | 1620 (80.48) | ||
≥2 | 44 (11.20) | 349 (88.80) | 393 (19.52) | ||
Training on medical emergency other than BLS [n(%)] | 18.93 | <0.01 | |||
No | 280 (16.57) | 1410 (83.43) | 1690 (83.95) | ||
Yes | 23 (7.12) | 300 (92.88) | 323 (16.05) |
Table 2
The frequency and number of medical emergencies reported by Chinese dentists participating the survey (n=2013)"
Category | Medical emergencies reported by a dentist | Total | ||||||
---|---|---|---|---|---|---|---|---|
0 | 1 | 2 | 3 | 4 | 5 | 6 | ||
Dentists [n(%)] | 303 (15.1) | 975 (48.4) | 418 (20.8) | 206 (10.2) | 73 (3.6) | 26 (1.3) | 12 (0.6) | 2013 |
Emergent events (n) | 0 | 975 | 836 | 618 | 292 | 130 | 72 | 2923 |
Table 3
Spectrum of the medical emergencies reported by Chinese dentists (n=2923)"
Type of emergency | Frequency | % |
---|---|---|
Syncope | 1050 | 35.9 |
Hypoglycemia | 885 | 30.3 |
Adrenalin reaction | 249 | 8.5 |
Allergy | 170 | 5.8 |
Local anesthetic intoxication and adverse reactions | 123 | 4.2 |
Aspiration and accidental swallowing | 117 | 4.0 |
Severe hypertension | 108 | 3.7 |
Epileptic seizure | 90 | 3.1 |
Orthostatic hypotension | 90 | 3.1 |
Heart diseases (myocardial infarction, angina pectoris, etc.) | 20 | 0.7 |
Airway obstruction | 12 | 0.4 |
Stroke | 9 | 0.3 |
Table 4
Details of 6 deaths associated with medical emergencies reported by Chinese dentists"
No. | Specialty and patient status | Type of facility | Type of emergency | Related dental procedure |
---|---|---|---|---|
1 | Pediatric dentistry (child) | Private dental clinic | Airway obstruction | Root canal treatment |
2 | Pediatric dentistry (child) | Private dental clinic | Cardiac arrest | Dental treatment under general anesthesia |
3 | Maxillofacial surgery (adult) | Public general hospital | Airway obstruction | Abscess incision and drainage |
4 | Maxillofacial surgery (adult) | Dental school hospital | Local anesthetic drug intoxication | Removal of impacted wisdom teeth |
5 | Prosthodontics (elderly with basic diseases) | Dental school hospital | Myocardial infarction | Tooth preparation |
6 | Endodontics (elderly with basic diseases) | Private dental clinic | Stroke | Root canal treatment |
Table 5
Practicing time of Chinese dentists and the number of medical emergencies encountered"
Category | Length of practicing time (years) | Total | ||||
---|---|---|---|---|---|---|
< 5 | 5-10 | 11-15 | 16-20 | >20 | ||
Dentists [n(%)] | 565 (28.1) | 554 (27.5) | 399 (19.8) | 219 (10.9) | 276 (13.7) | 2013 (100) |
Medical emergencies (n) | 672 | 753 | 579 | 362 | 557 | 2923 |
Average per dentist | 1.19 | 1.36 | 1.45 | 1.65 | 2.02 | 1.45 |
Table 6
Associated factors of Chinese dentists experiencing medical emergencies in the dental clinic"
Characteristics of dentists | Experiencing medical emergency (n=2013) | Experiencing multiple medical emergencies (n=1710) | |||||
---|---|---|---|---|---|---|---|
OR | 95% CI | P | OR | 95% CI | P | ||
Gender* | 1.02 | 0.78, 1.32 | 0.91 | 0.98 | 0.80, 1.20 | 0.850 | |
Age* (years) | |||||||
30-40 | 1.81 | 1.31, 2.51 | <0.001 | 1.11 | 0.83, 1.47 | 0.493 | |
41-50 | 2.17 | 1.50, 3.14 | <0.001 | 1.87 | 1.31, 2.67 | 0.001 | |
>50 | 6.10 | 3.39, 10.96 | <0.001 | 2.16 | 1.56, 3.00 | <0.001 | |
Length of practicing time* (years) | |||||||
5-10 | NA | NA | |||||
11-15 | NA | 0.59 | 0.41, 0.85 | 0.004 | |||
16-20 | 1.19 | 0.71, 2.00 | 0.52 | NA | |||
>20 | NA | NA | |||||
Number of specialty* | 1.25 | 0.87, 1.78 | 0.23 | 1.33 | 1.04, 1.71 | 0.023 | |
Training on medical emergency other than BLS* | 3.13 | 1.99, 4.94 | <0.001 | 1.09 | 0.84, 1.42 | 0.508 | |
Type of working facility* | |||||||
Private dental clinics or hospitals | 1.69 | 1.20, 2.38 | 0.003 | 0.78 | 0.59, 1.03 | 0.084 | |
Department of stomatology in general hospital | 1.33 | 0.93, 1.90 | 0.12 | 0.92 | 0.69, 1.23 | 0.568 | |
Other unspecified | 0.93 | 0.49, 1.74 | 0.81 | 0.83 | 0.46, 1.49 | 0.533 | |
Region of service* | |||||||
West China | 6.52 | 3.27, 13.04 | <0.001 | 0.93 | 0.69, 1.26 | 0.637 | |
Central/South China | 2.78 | 1.62, 4.77 | <0.001 | 1.88 | 1.38, 2.56 | <0.001 | |
Northeast China | 1.93 | 1.13, 3.30 | 0.02 | 0.88 | 0.56, 1.38 | 0.574 | |
East China | 1.28 | 0.90, 1.81 | 0.17 | 1.89 | 1.28, 2.80 | 0.001 | |
North China | 1.89 | 1.30, 2.73 | <0.001 | 2.21 | 1.52, 3.21 | <0.001 |
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