6. BLS, AED, team roles and documentation

Adult Basic Life Support

1. Ensure the safety of yourself, the patient and any bystanders.
2. Check for a response — shake gently and shout.
3. Open the airway using head tilt–chin lift and check for normal breathing for no more than 10 seconds.
4. If not breathing normally, call the emergency services and ask a colleague to fetch the AED.
5. Start chest compressions: centre of the chest, rate 100–120/min, depth 5–6 cm, allowing full recoil.
6. Combine with rescue breaths at a ratio of 30 compressions to 2 breaths, if trained and willing/able to do so.
7. Attach the AED as soon as it arrives and follow the voice/visual prompts.
8. Continue CPR until emergency help arrives, the patient shows signs of life, or you are too exhausted to continue.

Paediatric Basic Life Support

• Give 5 initial rescue breaths before starting compressions, if trained to do so.
• Use a compression-to-ventilation ratio of 15:2 for children when 2 or more rescuers trained in paediatric BLS are present; a single rescuer may use 30:2.
• Compression depth: approximately one-third of the depth of the chest; use one or two hands for a child, two fingers or one hand for an infant, as appropriate to size.

Automated External Defibrillator (AED)

• Switch on and follow the spoken/visual prompts; the device will analyse the rhythm and advise whether a shock is needed.
• Ensure no one is touching the patient during rhythm analysis and shock delivery.
• Paediatric pads/attenuators should be used for children under 8 years or under 25 kg where available; adult pads may be used if paediatric pads are not available.
• Continue CPR immediately after any shock, or as prompted by the device, and reassess every 2 minutes.

Team roles, communication and human factors

A well-rehearsed team response reduces delay and error. Example roles:

• Team member 1: stays with the patient, provides initial assessment and treatment, and leads the response.
• Team member 2: calls the emergency services and brings the emergency drugs and equipment/AED.
• Team member 3: meets the ambulance crew at the entrance and directs them to the patient.
• Team member 4 (where available): documents the timeline of events, drugs given and times, and supports other team members.

Effective communication (clear, closed-loop instructions), situational awareness and regular debriefing after drills and real events all improve outcomes.

Documentation, incident reporting and follow-up

Record in the patient’s clinical record as soon as practicable:

• A timeline of the event, including onset and duration of symptoms.
• Observations made and treatment given, including drugs, doses, routes and times.
• The patient’s response to treatment and their condition on discharge or transfer.
• Details of any handover to ambulance or hospital staff.
• Any onward referral or follow-up arranged.

Also review the event at a team debrief, replace any drugs/equipment used, and consider whether the duty of candour applies. Significant events should be logged for practice-level clinical governance/audit.

Course summary

Medical emergencies in dental practice, while uncommon, require prompt recognition and a calm, well-rehearsed team response. Good preparation — thorough medical histories, up-to-date emergency drugs and equipment, and regular practical training — remains the single most effective way to keep patients safe.

This written course supplements, but does not replace, mandatory hands-on practical BLS and medical emergency simulation training at least annually.

Before you take the assessment: locate your practice emergency drugs, oxygen and AED, and review your local emergency protocol against this course.