Chapter 2 - Emergency Procedures and Incident Reports


2-1. Fire or Disaster Situation (Code 17)

Remove persons in immediate danger of the fire.  Close doors to areas affected.

Activate the nearest fire alarm box and call PUBLIC SAFETY DIVISION at 12911.  Give the location of the fire.

Calmly notify other personnel in the area.

Attempt to extinguish the fire with the proper fire extinguisher provided in your area.

Follow established fire safety and evacuation procedures.  Escort patients from building.

Remain calm.  Never yell "FIRE."

2-2. Medical Emergencies  

A. Objective

The Dental Practitioner is constantly faced with the possibility of a medical emergency during the course of patient care. The practitioner must be prepared to handle such emergencies.  Our plan is to instill awareness in the faculty, students and staff of the Medical Emergency Protocol and a mechanism for its activation within The Dental College of Georgia.

B. Planning and Training

Each department is obligated to have its faculty maintain certification in CPR and to formulate its specific medical emergency plan and, if necessary, to activate the Medical Emergency Protocol formulated by the Oral and Maxillofacial Surgery Department at The Dental College of Georgia at Augusta University.  Compliance with the development of Departmental Medical Emergency plans will be monitored by the Oral and Maxillofacial Surgery Department.

It is the responsibility of the faculty/practitioner to provide initial management of the patient until the medical emergency response team arrives.  Therefore, it is recommended that each department have frequent scheduled and unscheduled medical emergencies practice sessions, as part of the medical emergency plan. Students, faculty, residents and staff involved in patient services must be CPR certified.  The student is advised to periodically review and mentally rehearse the steps, materials and drugs to be followed and used for a circulatory arrest emergency as presented in the course material of the Cardiopulmonary Resuscitation Course. An emergency action protocol should be posted by telephones in the clinics. This protocol should be memorized.

C. Emergency Equipment

Location of Emergency Equipment:  Emergency carts containing oxygen, resuscitation equipment and medications are located on each floor.  Two emergency carts are located on each patient care floor.

  • A wheelchair is located in the Oral Surgery Clinic for emergency use.

Oral Surgery is responsible for the monthly inspection of carts to determine if they are intact and stocked appropriately. They should also ensure the drugs on the cart are current and within date.

Eyewash units are available in sinks and various locations throughout the school to be used in cases of contamination of the eye(s) by chemical splash, foreign objects from grinding, etc. Please become familiar with the location of these units before you need it.

D. Medical Emergency Procedures

If you know that the patient is truly having an emergency crisis, notify those around you that a problem exists and take the following steps:

1. Call: 1-2222 which sends a page to appropriate Oral Surgery personnel.

2. Say: "Activate CODE #66 for a patient located in The Dental College of Georgia, ______ Floor, _____ clinic."

3. Send: individuals to the main elevators to direct first responder team.

4. Send: someone else to retrieve the emergency cart located closest to emergency.

5. If an ambulance is needed, call 1-2911.  Public Safety will contact 911 operator.

6. Send: Individuals to front and back of building to direct ambulance.

7. Maintain log of events. 

NOTE: If no response within two minutes, reactivate the initial Code and call 911.  

2-3. Accidental Injuries (Contact the Office Manager, Business Office) 

Should a patient accident/injury occur (related to dental therapy) the student should first report to the attending faculty member.

IF THE ACCIDENT IS LIFE THREATENING , follow the Medical Emergency Protocol for The Dental College of Georgia.

If the accident/injury is NOT life threatening, the student and patient should report to Admissions to fill out an "Employee's Report of Accident/Injury" form.  Detailed instructions for completing this form and follow-up activity (Emergency Room, blood testing, etc.) are available in Admissions.

If the accident/injury is NOT related to dental therapy , (patient falls, slips on wet floor, trips on stairs, etc.), the Admissions personnel will fill out the proper forms.  If medical treatment is required, activate the Medical Emergency Protocol for the DCG and notify public safety. 

Incident Reports

An incident is defined as adverse, unexpected occurrence of sufficient magnitude that it has the potential to be a risk management situation.  Examples of instances for which incident reports are necessary include (1) required emergency medical attention by persons other than the attending dental staff for medical situations arising during the course of treatment, (2) injuries to the patient of significant magnitude that they require medical or surgical intervention, (3) dental treatment which is so substandard as to be judged grossly negligent, (4) death.

2-4. Reporting needle sticks, cuts, and treatment related injuries

All needle sticks and sharp instrument injuries inflicted on students or faculty must be reported immediately. Students must notify their supervising faculty member. Exposures considered significant include:

  • Needle sticks with contaminated needles
  • Puncture wounds from contaminated, sharp dental instruments
  • Contamination of any obviously open wound or the mucous membranes with saliva, blood, or a mixture of both saliva and blood

   Exposure to a patient's blood or saliva on unbroken skin is not considered significant .

2-5. Event of an Injury

  1. In the event of a percutaneous injury, the Employee and/or Student will immediately stop the procedure in progress. Immediately cleanse the wound thoroughly with soap and water. 
  2. If a Patient, Employee, Student or Resident working, observing, or assisting on a patient is the recipient contaminant and the patient being treated is the source, the attending Faculty is notified immediately. The attending Faculty will stabilize the patient to a point that work may stop on the procedure in progress. If a Faculty member working on a patient is the recipient contaminant and the patient being treated is the source, another Faculty member will be called in to stabilize the patient to a point that work may stop on the procedure in progress. 
  3. The Business Office on the floor of the incident should be immediately notified by dialing:

    1st Floor - 1-9420

    2nd Floor - 1-9421

    3rd Floor - 1-9422

    4th Floor - 1-9423

  4. A Business Office employee will immediately notify Oral Surgery at 1-9744 that an Incident has occurred, and for a nurse to be ready to receive the source patient to draw blood for the lab.
  5. The Business Office representative will meet the recipient and source in clinic and will advise both recipient and source regarding procedure and will complete all required forms contained in a "percutaneous injury packet." 

The Percutaneous Injury Packet contains:

A. One (1) Blood/Body Fluid Exposure Form: This form requests information as needed and required by Student and Employee Health.

B. One (1) Clinical Immunology IV Lab Request Form: This form is a request for evaluation for blood work drawn on the Source. Evaluation includes testing for:

A. HILV-III Antibody (EIA)

B. HBsAg: RPR and HCV

C. Two (2) Consent for HIV Testing Forms: One form is read and signed by the Source and one is read and signed by the Recipient.

D. One (1) Augusta University Employee’s Report of Accident/Injury Form: This form is filled out in the event an Employee is involved.

E. One (1) Augusta University Student Incident Report: This form is filled out in the event a student is involved.  

6. The student/resident/faculty/employee patient/visitor will be instructed to report to the appropriate campus clinic (Student or Employee Health). The patient/visitor will be escorted to Oral Surgery by the Business Office representative.

Recipient: Recipient is defined as that person who experiences exposure (e.g., parenteral, mucous membrane, intact skin exposure, or puncture exposure) to blood or substances during a course of treatment.

A. Student: The Student will proceed directly to Student Health with a copy of the Post Exposure Source Patient Data Form and with the Blood/Body Fluid Exposure form.

1. Upon arrival to Student Health, the Student will sign in.

2. The Student will fill out the required forms and will be presented with a discharge form and counseled on the appropriate course of action to take until the results of the blood work of both the Recipient and the Source are determined. When blood is drawn on the Recipient, the ID number is followed with an “R” and the account number “A6001178” is also included on the label of the blood sample.

B. Employee/Faculty/Resident: The Employee/Faculty/Resident will proceed directly to Employee Health with a copy of the Post Exposure Source Patient Data Form and with the Blood/Body Fluid Exposure Form.

1. The Employee/Faculty/Resident will check in with Employee Health.

2. The Employee/Faculty/Resident will fill out the required forms and will be counseled on the appropriate course of action to take until the results of the blood work of both the Recipient and the Source are determined. When blood is drawn on the Recipient, the ID number is followed with an “R” and the account number “A6001178” is also included on the label of the blood sample.

C. Visitor/Patient: The Visitor or Patient will be escorted directly to Oral Surgery with the Clinical Immunology IV Lab Request Form.

1. The attending nurse in Oral Surgery will draw two (2) yellow topped vials of blood.

2. The specimens will be labeled with the Incident ID number followed by an “R” and the account number “A6001178” is also included on the label of the blood samples. The specimens will immediately be transported to the Pathology Lab by the attending Employee from Admissions.

Source: The Source is defined as that person from whom the contamination (e.g., parenteral, mucous membrane, intact skin exposure, or puncture exposure to blood or substances during a course of treatment) extends.

A. Student: The Student will proceed directly to Student Health with a copy of the Post Exposure Source Patient Data Form and with the Blood/Body Fluid Exposure form.

1. Upon arrival to Student Health, the Student will sign in.

2. The Student will fill out the required forms and will be presented with a discharge form and counseled on the appropriate course of action to take until the results of the blood work of both the Recipient and the Source are determined.  When blood is drawn on the Source, the ID number is followed with an “S” and the account number “A6001178” is also included on the label of the blood sample.

B. Employee/Faculty/Resident: The Employee/Faculty/Resident will proceed directly to Employee Health with a copy of the Post Exposure Source Patient Data Form and with the Blood/Body Fluid Exposure Form.

1. The Employee/Faculty/Resident will check in with Employee Health.

2. The Employee/Faculty/Resident will fill out the required forms and will be counseled on the appropriate course of action to take until the results of the blood work of both the Recipient and the Source are determined. When blood is drawn on the Recipient, the ID number is followed with an “R” and the account number “A6001178” is also included on the label of the blood sample.

C. Visitor/Patient: The Visitor or Patient will be escorted directly to Oral Surgery with the Clinical Immunology IV Lab Request Form.

The attending nurse in Oral Surgery will draw two (2) yellow topped vials of blood. The specimens will be labeled with the Incident ID number followed by an “S” and the account number “A6001178” is also included on the label of the blood samples. The specimens will immediately be transported to the Pathology Lab by the attending Employee from Admissions.

A copy of the Blood/Body Fluid Exposure Form, Augusta University Student Incident Report and/or Augusta University Employee’s Report of Accident/Injury Form, and Consent for HIV Testing Forms are filed in a secured location in Admissions.

The clinic or area responsible for obtaining the result of the blood tests (of both Recipient and Source) as well as providing post-test counseling is dependent on who is directly involved (i.e., the Recipient and/or Source). The following dictates who is responsible:

Student – Student Health

Employee/Faculty/Resident – Employee Health

7. In the event that a Blood Pathogen Exposure occurs after the Source has left, every attempt must be made to contact the Source as soon as possible to return for to have blood drawn for testing.

8. The Source has the right to refuse counseling and testing. If the Source is a patient, The Dental College of Georgia reserves the right to refuse further treatment of that patient until testing is completed.