Risk Management Tools & Resources


Three Essential Elements of Patient Care and Their Role in Medical Emergency Prevention

Three Essential Elements of Patient Care and Their Role in Medical Emergency Prevention

Laura M. Cascella, MA

Medical emergencies — such as cardiac arrest, loss of consciousness, allergic reactions, and respiratory distress — can occur anywhere, including healthcare offices and facilities. Although some medical emergencies are inevitable, others can potentially be avoided through careful patient evaluation and assessment.1 Several steps in the patient care process are critical in the prevention effort, including the medical questionnaire, the doctor–patient encounter, and the physical exam.

First, the medical questionnaire — completed by the patient or a parent/caregiver prior to seeing the doctor — provides an initial glimpse of the patient's current health status and medical history. The information provided in the patient questionnaire is of paramount importance, and it should be updated regularly and reviewed at each patient encounter.

Second, during the patient's appointment, the practitioner should review the questionnaire and ask for clarification or additional information about any conditions the patient has reported. For example, if the patient is diabetic, the practitioner might inquire about management of blood sugar levels. If the patient has previously had a heart attack, the practitioner may ask about any ongoing symptoms, such as shortness of breath. The additional information gleaned during this process may reveal potential red flags for a medical emergency.

Third, the physical exam gives the healthcare provider an opportunity to evaluate the patient's physical condition and determine whether the patient has any visible signs of illness or distress. For example, a phobic patient might appear agitated or nervous, even if he or she has not verbalized any anxiety. Additionally, the physical exam allows the provider to obtain baseline vital signs, a valuable tool for monitoring the patient before, during, and after treatment and recognizing signs of distress.2

The information gathered from these three elements of the patient care process — the medical questionnaire, the provider–patient encounter, and the physical exam — can help the practitioner proactively assess the patient's risk of a medical emergency.

If the level of risk is concerning, the practitioner may want to consider (a) whether a consultation with a colleague, specialist, or other provider would be beneficial; (b) whether the treatment plan should be modified, or (c) whether the patient should be treated in a hospital.

1 Stein, P. S. (2004). Medical emergencies in dentistry: Prevention and preparation. Dentistry IQ. Retrieved from http://www.dentistryiq.com/articles/wdj/print/volume-2/issue-10/you-and-your-practice/medical-emergencies-in-dentistry-prevention-and-preparation.html

2 Malamed, S. F. (2010). Knowing your patients. Journal of the American Dental Association, 141(Suppl 1), 3S–7S.

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