Do dental staff need to be trained in CPR?
All dentists and clinical staff must have the training and ability to perform basic life support (BLS) techniques. It is strongly recommended that all dentists maintain current BLS certification (CPR Level HCP), and that all dental offices are equipped with an automated external defibrillator (AED).
All dentists providing sedation must, as a minimum, maintain current BLS certification (CPR Level HCP), which must include a hands-on component. Please refer to that table for specific requirements for each modality (link to Table https://www.rcdso.org/en-ca/rcdso-members/running-your-practice/sedation-and-anesthesia/frequently-asked-questions)
Currently, in-person training is available in most jurisdictions. If in-person training is not available in your area please see below.
Yes. The College has approved multiple Category 1 courses on medical emergency preparedness by various presenters.
The College defines “current” as within 2 years.
There are six basic drugs that must be included in the emergency kit of every dental office: oxygen, epinephrine, nitroglycerin, diphenhydramine, salbutamol inhalation aerosol and ASA (non-enteric coated).
The emergency drugs must have current dates and be stored in a readily identifiable and organized fashion (e.g. labelled trays or bags).
The following table presents the six basic drugs and their recommended dosages.
An E-size cylinder is required. The unit must be portable and have an appropriate regulator and flowmeter, as well as connectors, tubing and reservoir bag, to allow use of a full face mask for resuscitative ventilation.
All dentists and dental office staff must be prepared to recognize and treat adverse responses using appropriate emergency equipment and appropriate and current drugs when necessary. The College recommends your office have an emergency protocol. All office staff should be aware of this protocol and the procedures to follow when a medical emergency arises. Review the protocol at staff meetings so everyone is clear about who does what when a medical emergency occurs.
Dentists and staff are advised to check with the WSIB and/or the course providers, such as the Red Cross or Heart and Stroke to determine if a grace period has been provided.
Where feasible, continue to take advantage of the grace periods provided to defer in-person training, if suitable training is not available in your area. Where training is required, and you have internet access, please utilize Blended Learning options for BLS or Interim Training Courses for BLS, ACLS & PALS for the cognitive portion of courses.
WSIB will accept the Online Portion of the blended Training Program as a valid interim certificate during the social distancing protocols. When permissible by municipal, provincial, and federal legislation or regulation, obtain the second part for Skills for Interim Training/Interim Self-Directed Learning or, if available, in-classroom courses in alignment with In-Person Training and mandatory guidelines from Public Health and other governing authorities.
Reduce provider exposure to COVID-19 by donning appropriate PPE and limiting personnel in the operatory. Prioritize oxygenation and ventilation strategies with lower aersolization risk including the use of a HEPA filter for all ventilation and if sufficient for adults consider passive oxygenation with a non-rebreathing face mask for short durations as an alternative to bag-mask. Performing the all-important chest compression is not an AGMP while manual ventilation and possibly intubation (if trained to do so) are considered to be AGMPs. This means that chest compressions may begin right away. The person performing manual ventilation (and intubation if completed) should put on their N95 respirator, wear eye protection and other appropriate PPE. Consider having a respirator (the type most commonly worn), eye protection and other appropriate PPE as part of your emergency set-up.
Refer to the downloadable algorithms at:
The following information is provided from Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19; Originally published 9 Apr 2020 https://doi.org/10.1161/CIRCULATIONAHA.120.047463 Circulation
https://www.publichealthontario.ca/-/media/documents/ncov/ipac/faq-covid-19-aerosol-generating-medical-procedures.pdf?la=en
