How to Respond to an Anaphylactic Medical Emergency

Medical Emergency Readiness

While allergy-related medical emergencies are rare at the dentist’s office, they do occur.  Well-trained and well-equipped dental staff can be a lifesaver. During National Asthma and Allergy Awareness Month, make sure you’re ready to provide medical aid in the event of anaphylaxis.

According to noted dentist anesthesiologist Dr. Stanley F. Malamed, the success of emergency response depends on having epinephrine auto-injectors on hand and being trained in using them.

That’s why Dr. Malamed, a professor of anesthesia and medicine for 45 years and member of the HealthFirst Medical Advisory Board, calls epinephrine auto-injectors indispensable.

“Epinephrine is the most important drug in the dental practice medical emergency kit,” according to Dr. Malamed.

“The pre-loaded auto-injector epinephrine syringe is a critical component of the dental office emergency kit,” he says. “I recommend having two 1:1,000 auto-injector syringes (a “2-Pak”) for the >30 kg patient and, if appropriate, two 1: 2,000 auto-injectors for patients weighing less than but up to 30 kg.”

Five Steps to Manage Anaphylactic Reaction

In order of importance, follow these steps in the management of an acute anaphylactic reaction, per Dr. Malamed:

  • Administer epinephrine
    • If using an auto-injector, the dose is calculated for you
    • If administering from a vial, the adult dose will vary from 0.3 to 0.5 mg per injection
      • For pediatric dosing, or for more information on administering epinephrine from a vial, see this video
  • Position the patient (supine feet elevated, if unconscious; comfortable, if conscious)
  • Administer portable oxygen
  • Call emergency medical services (One staff member should call at the onset of an emergency, while a second staff member is providing care)
  • Be prepared with back-up epinephrine for a bi-phasic reaction, which occurs in approximately 20% of anaphylactic reactions.

Equip Your Practice for Emergency Response

HealthFirst is here to help you be ready for the often-severe reactions your food-allergic patients might experience.  Product, services and training resources include:

Practice readiness questions?

Contact a HealthFirst Readiness Advisor or call 800-331-1984.


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