Recently, a 24-year-old man went into cardiac arrest during oral surgery to have his wisdom teeth removed. The exact cause of the cardiac arrest has not been identified, but it is known that some people can suffer a cardiac arrest while under sedatives. The man died three days later in the hospital and his family is questioning the medical care he received during the oral surgery. I am sorry for their loss and while I don’t want to speculate on correct surgical procedure, I do want to take this opportunity to explore why all dentists should have an automated external defibrillator (AED).
Paul Asted, an EMT and instructor at the Minnesota Dental Association believes dentist offices should have AEDs and creates this scenario: “Your patient is a 62-year old woman with a history of hypertension and congestive heart failure. Today you are extracting a molar. Suddenly your patient’s eyes open wide; she gasps, stiffens and goes completely flaccid. You call her name with no response. She is unresponsive to a sternal rub. You check her breathing and pulse and find that both are absent.” He goes on to say that you can take all the necessary steps like calling 911 and performing CPR, but typically, emergency services won’t arrive till 5-10 minutes after the call and if the patient has not received defibrillation, the odds are highly against her surviving.
The scenario Asted posed has become much more common and as we can see from the recent example, cardiac arrest happens to 24-year-olds and not just people that seem at high-risk. AEDs are the best form of pre-emergency service care as they have the ability to detect heart signals and instruct the user whether a shock or more CPR is needed.
Currently there are a few states that require AEDs in dentist offices that use conscious sedation, including states like TN, FL and GA, but there aren’t many states that require all offices to have one regardless of sedative use. NY put a law into place last year that required all dentistry’s to have an AED. The legislature was supported by the New York State Dental Association because their offices are a location that people all over the demographic scale frequent and AEDs have proven to greatly improve outcomes for people experiencing cardiac arrest.
As more cases of cardiac arrest at dentistry’s are reported, I’m not really sure why more states haven’t followed NY’s example, but I will say that just because a state hasn’t mandated something doesn’t mean it shouldn’t be done. There is a concept called “standard of care,” which simply put, is the standard a community expects from an organization’s services. In a perfect world we would see every dentistry respond to tragedies and implement an AED program, but sometimes it is up to the community to hold them responsible to a standard of care.
So, at your next dental visit, look around, or ask your dentist to see if they have an AED. And dentists, it is becoming easier to protect your office with an AED as many distributors including AED.com put together AED dental packages built to specially meet an office’s needs. Maybe not everyone really likes going to the dentist, but it can at least be a place where you can feel a little safer.