C.E. Credit. Management of Hypertensive Crisis in a Dental School: 10-year Retrospective Review of Medical Emergency Incidents With Recommendations

ABSTRACT

Background: The objective of this study was to analyze the type and frequency of medical emergency calls made at the Loma Linda University School of Dentistry (LLUSD) and to reinforce the guideline for the most frequent incident.

Methods: Emergency call data from the past 10 years at LLUSD were collected and categorized according to the type and frequency of medical emergencies. The most frequent emergency data was identified, and additional information was gathered using the patients’ electronic health records in the axiUm database.

Results: Emergency calls related to hypertension (HTN) were the most common emergency calls encountered at LLUSD and comprised 32.9% of the calls (95% confidence interval (CI): 29.1, 36.9). HTN-related calls peak at age groups 50 to 80 (P < 0.05). Seventy-seven percent of patients who had emergency calls had an existing HTN. Out of the total HTN incidences, 11% were transported to the emergency room (ER) (95% CI: 7.86, 12.2).

Conclusions: The most frequent medical emergency call at LLUSD was related to hypertension. A revised HTN guideline is recommended to guide dental providers to determine when to call emergency medical service (EMS) or when to consider a medical consultation with a patient’s physicians to minimize reports that do not require immediate management. Providers must also consider the patient’s individual health history, background and comorbidity.

Practical implications: The proposed updated HTN treatment guideline will guide dentists or staff on whether to call EMS for immediate treatment or refer to a patient’s physician for HTN care.

Keywords:

• Medical emergency
• hypertension
• hypertensive emergency
• hypertensive urgency
• guideline

Additional information

Notes on contributors

Soh Yeun Kim

Soh Yeun Kim, DDS, is an assistant professor and course director of patient-centered care II at the Loma Linda University School of Dentistry.

Sarah Lim

Sarah Lim, BA, is a fourth-year dental student at the Loma Linda University School of Dentistry.

Lauren Barlow

Lauren Barlow, BS, is a fourth-year dental student at the Loma Linda University School of Dentistry.

Chanmee Esther Kim

Chanmee Esther Kim, BS, is a fourth-year dental student at the Loma Linda University School of Dentistry.

Adlene Chang

Adlene Chang, BA, is a fourth-year dental student at the Loma Linda University School of Dentistry.

Holli Riter

Holli Riter, DDS, is an associate professor and a director for the special care dentistry department at the Loma Linda University School of Dentistry.

Iris Nam

Iris Nam, DDS, is an assistant professor and clinician in the special care dentistry department at the Loma Linda University School of Dentistry.

Heidi Christensen

Heidi Christensen, DDS, is a professor and patient care manager at the Loma Linda University School of Dentistry.

Udochukwu Oyoyo

Udochukwu Oyoyo, MPH, is an assistant professor and statistician at the Loma Linda University School of Dentistry.