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A gestão de reações alérgicas graves e anafilaxia pelo médico dentista
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Abstract(s)
As reações anafiláticas, embora raras no consultório de medicina dentária, representam uma emergência com risco de morte que qualquer médico-dentista pode ser chamado a enfrentar no seu consultório. Estas reações podem manifestar-se de forma inesperada e aguda em resposta a muitas substâncias utilizadas diariamente na prática dentária, mas com potencial alergénico, tais como medicamentos ou materiais restauradores dentários.
Estas reações anafiláticas, quando não diagnosticadas atempadamente, podem evoluir para quadros graves e consequentemente resultar em quadros fatais.
Neste sentido, vários protocolos e recomendações foram implementados na prática para otimizar o atendimento em situações de emergência.
Este trabalho centra-se na abordagem da anafilaxia no consultório de medicina dentária, com base numa análise do enquadramento regulamentar nacional, bem como das recomendações clínicas atuais para os cuidados.
Através de uma revisão narrativa de literatura, o estudo evidencia várias deficiências. De facto, os profissionais de saúde não possuem as competências teóricas e práticas necessárias para atuar em situações de emergência. Estas insuficiências podem ser atribuídas a métodos de formação inadequados à memorização e aplicação prática dos procedimentos, bem como a diretivas que, por vezes, se encontram distantes das condições reais observadas na prática clínica.
Anaphylatic reactions, although rare in the dental office, constitute life-threatening emergencies that any dentist may be required to manage in their practice. These reactions can occur suddenly and acutely in response to a variety of substances used daily in dentistry, but with allergenic potential that can cause these reactions, such as medicines or dental restorative materials. These anaphylactic reactions, if not promptly diagnosed, can rapidly progress to severe and potentially fatal outcomes. In response, numerous protocols and guidelines have been established in order to optimize the management of emergency situations. This study focuses on the approach to anaphylaxis in the dental office, based on an analysis of the national regulatory framework, as well as current clinical guidelines for care. Based on a narrative literature review, the study highlights several gaps. In fact, dentists lack the theoretical and practical skills needed to act in emergency situations. These shortcomings may be attributed to training methods that are inadequate for effective memorization and practical application of procedures, as well as guidelines that, at times, are disconnected from the real-world conditions encountered in clinical practice.
Les réactions anaphylactiques, bien que rares au cabinet dentaire, représentent une urgence vitale que tout dentiste peut être amené à gérer dans sa pratique. Elles peuvent se manifester de manière inattendue et aiguë en réponse à de nombreuses substances utilisées quotidiennement au cabinet dentaire, mais présentant un potentiel allergénique susceptibles de provoquer ces réactions tels que les médicaments ou encore les matériaux de restauration dentaire. Ces réactions anaphylactiques, lorsqu’elles ne sont pas directement diagnostiquées, peuvent évoluer vers des formes cliniques sévères. Ainsi, plusieurs protocoles et recommandations ont été mis en place pour optimiser la prise en charge en situation d’urgence. Ce travail s'intéresse à la gestion de l’anaphylaxie au cabinet dentaire, en s’appuyant sur une analyse du cadre réglementaire national ainsi que les recommandations cliniques actuelles concernant la prise en charge clinique. De ce fait, l’étude narrative menée met en évidence plusieurs lacunes. En effet, les professionnels de santé ne disposent pas des compétences théoriques et pratiques nécessaires pour faire face à des situations d'urgence. Ces insuffisances peuvent être attribuées à des méthodes de formation inadaptées à la mémorisation efficace et à leur mise en pratique, ainsi qu’à des directives parfois éloignées des conditions réelles rencontrées en pratique clinique.
Anaphylatic reactions, although rare in the dental office, constitute life-threatening emergencies that any dentist may be required to manage in their practice. These reactions can occur suddenly and acutely in response to a variety of substances used daily in dentistry, but with allergenic potential that can cause these reactions, such as medicines or dental restorative materials. These anaphylactic reactions, if not promptly diagnosed, can rapidly progress to severe and potentially fatal outcomes. In response, numerous protocols and guidelines have been established in order to optimize the management of emergency situations. This study focuses on the approach to anaphylaxis in the dental office, based on an analysis of the national regulatory framework, as well as current clinical guidelines for care. Based on a narrative literature review, the study highlights several gaps. In fact, dentists lack the theoretical and practical skills needed to act in emergency situations. These shortcomings may be attributed to training methods that are inadequate for effective memorization and practical application of procedures, as well as guidelines that, at times, are disconnected from the real-world conditions encountered in clinical practice.
Les réactions anaphylactiques, bien que rares au cabinet dentaire, représentent une urgence vitale que tout dentiste peut être amené à gérer dans sa pratique. Elles peuvent se manifester de manière inattendue et aiguë en réponse à de nombreuses substances utilisées quotidiennement au cabinet dentaire, mais présentant un potentiel allergénique susceptibles de provoquer ces réactions tels que les médicaments ou encore les matériaux de restauration dentaire. Ces réactions anaphylactiques, lorsqu’elles ne sont pas directement diagnostiquées, peuvent évoluer vers des formes cliniques sévères. Ainsi, plusieurs protocoles et recommandations ont été mis en place pour optimiser la prise en charge en situation d’urgence. Ce travail s'intéresse à la gestion de l’anaphylaxie au cabinet dentaire, en s’appuyant sur une analyse du cadre réglementaire national ainsi que les recommandations cliniques actuelles concernant la prise en charge clinique. De ce fait, l’étude narrative menée met en évidence plusieurs lacunes. En effet, les professionnels de santé ne disposent pas des compétences théoriques et pratiques nécessaires pour faire face à des situations d'urgence. Ces insuffisances peuvent être attribuées à des méthodes de formation inadaptées à la mémorisation efficace et à leur mise en pratique, ainsi qu’à des directives parfois éloignées des conditions réelles rencontrées en pratique clinique.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Anafilaxia Médico-Dentista Gestão de emergência Reação alérgica