#11 – Screening Emergencies

We can help patients in pain. With well-trained clinical staff and knowledgeable administrative team members, we can work together to take care of people in a kind and caring way. In this section you will learn how to handle emergency patients so that they are seen in a timely manner and supported in a caring way.

Our job is also to manage these emergencies in a way that doesn’t completely destroy our existing patient schedule. It’s just not fair to make existing patients who scheduled appointments wait to be seen. So, your job is to plan for emergencies, know how to schedule them appropriately and then handle their checkout successfully.

You do not have to decide if the patient is a “real emergency” or not. If the person seems to be upset or concerned and asks to be seen same day, then it is okay to treat them as an emergency. And, you can do this because you have a plan for handling these patients.

Emergency Phone call

Emergency patients generally call in and ask for an appointment as soon as possible. When you recognize that you have an emergency patient on the phone, grab an emergency form and fill out the top questions.

To download a copy of the emergency form: Emergency exam form

The questions include:

  • Patient’s name
  • Weight (if under age of 14 only) ______
  • Chief complaint and history
  • Is one of your teeth broken or have a hole in it?
  • Is there any swelling?
  • When did you first notice the problem?
  • Are you having pain? When did it start?  Is it sharp or dull, continuous or throbbing?
  • Do you know which tooth?
  • What makes tooth hurt: hot, cold, bite
  • Do you have any sensitivity to biting pressure   Yes / No
  • If patient is new, ask “How did you find out about our office”
  • When would you like to be seen?

You can create a clinical note template in the tooth chart for Emergencies using these questions. If you choose to do that, then simply:

  1. Open tooth chart
  2. Click on “Clinical Notes” tab at bottom.
  3. On the right side column, click “Administrative” and scroll down.
  4. Double click on “Emergency” at the bottom of the list
  5. Answer all of the questions.
  6. Put your initials at the bottom. Change the provider to the correct doctor the patient is scheduled to see in the notes. DO NOT SIGN!!! . Do not use the pen icon and sign. The doctors may need to edit this information.

Scheduling the Emergency Appointment

All emergencies are scheduled for 30 minutes with a member of the staff.  If a doctor has open time, try to get the emergency in BEFORE the doctors’ opening.  This may mean you not only can fill the doctor’s schedule, but also get treatment for the client quickly.

In the appointment notes, please insert dateline and type a brief synopsis of the problem the patient is having – based on your questions above.

If the patient refuses to come in today, be sure to document this in their clinical notes. By making this note, the dentist can see why the patient called in two days ago in pain but wasn’t seen immediately. If this happens, then your responsibility is only to give them the first open appointment that is convenient for them.

What if they owe money?

Additionally, it is your responsibility to let the doctor and his staff know if the patient has an outstanding balance (already on a contract, sent to collections in the past or written off in the past).  Make a note in the appointment and clinical notes concerning the balance so the doctor and his staff will be sure to have financial arrangements done with a front staff person before any treatment is done.  If the doctor decides to do treatment without financial arrangements, put a note in the system to that effect.

Here are some “home remedy” ideas to help your clients be comfortable until they can get in to see us:

Toothache – Floss both sides of the tooth gently; Rinse with warm water to remove any food. Crushed ice compress on cheek if there is swelling – no heat; NO ASPIRIN against the tooth; the acid can burn the gums.Use Ibuprofen – 4 tablets every 6-8 hours.

Broken tooth or filling – Rinse with warm water; avoid extremely hot/cold things; Wet cotton or sugarless gum can fill the area and protect the cheek and tongue

Knocked out tooth – Have them come in immediately, then worry about who will help. Tooth must be back in the socket in 30 minutes! Don’t touch the root of the tooth.Don’t clean the tooth. Tell the patient to put the tooth in container of milk (very near the composition of body fluids).

Broken braces or wire- Cover with wax, cotton, or chewing gum; Remove wire if it will come out. Bring any loose pieces with you.

Cut tongue, cheek, lip – Gently rinse mouth with cold water; Apply pressure to cut with clean, moist towel.If blood spurts and doesn’t stop, go to hospital emergency room

Swelling with or without pain – This is a sign of serious infection. See a dentist immediately or go to hospital emergency room.

Possible broken jaw – Immobilize jaw with scarf or towel. Apply crushed ice compress gently (reduce swelling). Go to the hospital.

Loose crown – Try to re-cement temporarily with denture adhesive.

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Team Leader                                                     Date