Medical emergencies during dental procedures test rapid recognition and management skills, forming a recurring high-yield segment in UPPSC Dental Surgeon exams with scenario-based MCQs.
Why This Topic Dominates UPPSC
UPPSC emphasizes chairside emergencies over rare syndromes, mirroring real-world BPHU practice where quick ABC stabilization saves lives. Expect 6-8 questions on protocols, drug dosages, and prevention—prioritize over complex surgeries.
Core Emergencies and Protocols
- Syncope (Vasovagal): Most common; patient pale, sweaty. Position Trendelenburg (legs up), airway open, ammonia inhalant, monitor vitals.
- Asthma Attack: Wheezing, dyspnea. Stop procedure, salbutamol inhaler (2 puffs), oxygen; severe cases get epinephrine 0.3mg IM.
- Anaphylaxis: Urticaria, hypotension post-LA. Epinephrine 1:1000 (0.3-0.5mg IM every 5 min), antihistamine, steroids; call 108.
Cardiovascular and Metabolic Crises
Emergency
|
Key Signs
|
Immediate Action
|
| Angina/MI |
Chest pain, dyspnea |
GTN 0.4mg SL (if BP stable), aspirin 300mg, oxygen, emergency call. |
| Hypoglycemia |
Sweating, confusion |
15g glucose gel/oral; glucagon 1mg IM if unconscious. |
| Hyperglycemia |
Polyuria, Kussmaul breathing |
Check BS, fluids, insulin if known diabetic; hospitalize. |
| Adrenal Crisis |
Hypotension in steroid patients |
Hydrocortisone 100mg IV, glucose, fluids. |
Neurological and Respiratory Must-Knows
- Epilepsy: Protect airway, midazolam 10mg buccal/IN; diazepam 10mg IV if prolonged.
- LA toxicity: CNS excitation first (tinnitus, seizures), then depression—supportive care, benzodiazepines, lipid emulsion 1.5ml/kg for bupivacaine.
- Foreign body aspiration: Heimlich, back blows; bronchoscopy referral.
UPPSC 2026 Predicted “Tricky” Question
Q: A patient starts having a seizure while in the dental chair during an extraction. What is the most
important first step?
- A) Force a mouth prop between the teeth.
- B) Give IM Midazolam immediately.
- C) Clear the area and lower the chair to a supine position.
- D) Restrain the patient’s arms.
Correct Answer: C. In the screening test, always look for the most conservative/safe initial step. You never put anything in the mouth during a seizure or restrain the patient