Medical emergencies

All registrants must follow the guidance on medical emergencies and training updates issued by the Resuscitation Council (UK).

The Resuscitation Council's document Quality Standards: Primary dental care is its main medical guidance document for dental professionals. We endorse this document and expect registrants to apply this guidance in practice.

Equipment requirements – defibrillators and emergency drugs

​Defibrillators

We endorse the Resuscitation Council's guidance that  all clinical areas should have immediate access to an automated external defibrillator (AED).

What does this mean in practice?

Premises in which patients are seen clinically should have a defibrillator. This includes practices in which patients are seen by:

• A dentist only
• A clinical dental technician only
• A dental hygienist or dental therapist only
• A combination of members of the dental team

Emergency drugs

We endorse the Resuscitation Council's guidance that clinical dental settings staffed by dentists, hygienists, and therapists, are to have an emergency drugs kit. Further guidance on what drugs should be contained in emergency drugs kits can be found in the British National Formulary on the National Institute for Health and Care Excellence (NICE) website.

Clinical dental technicians: We recognise that the Human Medicines Regulations 2012 prohibit clinical dental technicians from purchasing or holding the prescription-only medicines contained within an emergency drugs kit. We do not therefore expect a clinical dental technician to have an emergency drugs kit or be trained in the use of an emergency drugs kit. We are aware that CDTs who work independently will not have an emergency drugs kit on their premises.

A practice led by a dental hygienist or dental therapist (i.e. a dentist is not present): A dental hygienist / therapist practice needs to ensure that they hold emergency drugs on site.   

All medicines currently on the Emergency List with the exception of midazolam (see paragraph below) can be ordered, stored and administered by a dental hygienist or a dental therapist assessed as being competent and working to a Patient Group Direction (PGD). This is because the Human Medicines Regulations 2012 allows them to administer or supply medicines that are not controlled drugs under a PGD. 

Midazolam, which is one of the drugs on the Emergency List, is a controlled drug (see The Misuse of Drugs Regulations 2001 (MoDR 2001)). Under these Regulations, dental hygienists and dental therapists do not have the authority to possess or administer midazolam in their own right. They are only able to possess or administer midazolam when acting under the directions of a dentist (or doctor), through a prescription under a Patient Specific Directive. The dentist must be assured that the dental hygienist or dental therapist has been trained and is competent to administer midazolam. The dentist does not need to be on site when the midazolam is administered. 

Dental therapists and dental hygienists working in their own practices need to assess the risk of treating a patient without a dentist available, taking into account the patient’s medical history. This is particularly important for patients with uncontrolled epilepsy being considered for dental treatment, who may be too high risk to treat without access to midazolam.

Staff skills requirements

A patient could collapse on any premises at any time, whether they have received treatment or not. It is therefore essential that all registrants must be trained in dealing with medical emergencies, including resuscitation, and possess up to date evidence of capability.

Scope of practice

Registrants must know their role in the event of a medical emergency, and ensure they are sufficiently trained and competent to carry out that role.

If the setting in which you work changes, your role in the event of a medical emergency may change as well. You must ensure that you are suitably trained and competent to carry out your new medical emergency role. This might be the case for:

• A dental hygienist moving to independent practice under direct access.
• A clinical dental technician moving from a dentist's premises to independent premises.
• A dental nurse working in a school.
• A dental nurse assisting with domiciliary visits.