National Dental Advisory Committee - Emergency Drugs & Equipment in Primary Dental Care

Report on the use of emergency drugs and equipment in Primary Dental Care.

Emergency drugs in the dental practice

You must ensure that the following drugs are available at all times.

1. Glyceryl trinitrate spray (400 µg per metered dose)

2. Salbutamol inhaler (100 µg per activation)

3. Adrenaline (1 ml ampoules or pre-filled syringes of 1:1000 solution for intramuscular injection)

Note that pre-filled syringes are useful in an emergency situation for ease of use.

4. Aspirin (300 mg dispersible tablets)

5. Glucagon (for intramuscular injection of 1 mg)

6. Oral glucose/sugar (several alternative forms are available commercially including non-diet fizzy drinks, glucose gel, powdered glucose and sugar lumps)

7. Midazolam buccal liquid (10 mg/ml), or Midazolam injection (as hydrochloride) (5 mg/ml 2 ml ampoules) for topical buccal administration

8. Oxygen cylinder:

Size: Every practice should have sufficient oxygen to ensure at least 30 minutes supply at 15 litres/minute. Three main sizes of cylinder are in current use in dental practices:

  • A full Size D cylinder contains 340 litres of oxygen and will provide oxygen for less than 30 minutes;
  • A full Size CD cylinder contains 460 litres of oxygen and should provide oxygen for 30 minutes;
  • A full Size E cylinder contains 680 litres of oxygen and should provide oxygen for up to 45 minutes.

An urban practice should either have two Size D or two Size CD or one Size E cylinder. In rural areas the ambulance response times may be prolonged. In these circumstances additional cylinder capacity may be required to ensure that a collapsed patient can be adequately maintained on oxygen. In order to achieve this it is recommended that rural practices should have two E cylinders.

Flow: The oxygen cylinder should provide flow of at least 15 litres per minute.

Serviced: at least every 5 years (or according to manufacturer's instructions).

Charged: at least 75% full and evidence of regular checks.

Note: some cylinders have a built-in regulator whereas others have a bolt on regulator; these are not interchangeable; dental staff should ensure there is awareness of the type of cylinder in use and that spare cylinders are useable.

9. Flumazenil (0.5 mg/ 5 ml): only required for those dental settings where conscious sedation is undertaken using benzodiazepines.


Email: Elizabeth Mclear

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