pulse of its own and will confuse your counting. To
determine the pulse, once you feel the artery beating,
count the beats for 30 seconds, multiply by 2, and then
record the results.
If you notice any irregularity, take the patients
pulse again. This time, however, count the beats for a
full minute. If the pulse is still irregular in rate or
rhythm, inform the dental officer.
The other common site for taking the pulse is the
radial artery on the thumb side of either wrist (fig. 9-2).
If you are taking the pulse at the radial artery, have the
patient place his arm in a relaxed position on the arm of
the dental chair. Lightly rest your index and middle
finger on the patients radial artery to determine pulse.
Blood pressure is the force that the blood exerts
against the walls of the arteries as it flows through the
The maximum blood pressure occurs when the
heart contracts. This is referred to as the systolic
Norma1 blood pressure range for the
systolic reading for an adult is 90 to 140 millimeters of
mercury (mm Hg).
The minimum blood pressure occurs when the
heart relaxes. This is referred to as the diastolic
pressure. Normal blood pressure range for the
diastolic reading for an adult is 60 to 90 mm Hg.
Take the blood pressure of each patient over the
age of 5 at the initial and annual examinations, or when
directed by the dentist. Record the results on the
Figure 9-2.Taking the radial pulse.
patients Dental Exam Form. An entry of 120/80 would
indicate the systolic pressure is 120 mm Hg
(millimeters of mercury) and the diastolic pressure is
80 mm Hg.
Blood pressure is measured with a sphygmo-
manometer and a stethoscope or an electronic unit that
provides a digital reading. Follow manufacturers
instructions for use and maintenance of your particular
Respiration is the act of inhaling and exhaling.
One inhalation and one exhalation is a complete cycle.
The respiration rate for an adult may range from 12 to
15 cycles per minute; for a child the rate is 15 to 18
cycles per minute; and for an infant the rate is 18 to 20
cycles per minute.
Respiration can be controlled by the patient. To
obtain an accurate respiration rate without the patients
knowledge, watch the chest rise and fall, and count the
EMERGENCY RESPONSE TEAM
Your command will have an emergency response
team that is appointed by the commanding officer or
branch director. This team responds to all emergencies
when called upon. It consists of at least one dental
officer and two dental technicians. It is activated by
the front desk personnel and announced over the
clinics loud speaker system. An example of this may
be as follows: attention in the clinic, code blue in dental
treatment room five. The front desk personnel should
repeat this message twice. Your command instruction
will have specific guidelines for announcing the
When activated the appointed dental officer goes
directly to the emergency and the technicians
appointed retrieve the medical emergency equipment
and bring it to the scene. A mobile crash cart is
brought to the emergency and will consist of an
automated external defibrillator and emergency drugs.
A portable unit of oxygen is also brought. The oxygen
tank is an E size cylinder that provides approximately
78 liters of oxygen per minute for one-half hour. An
extra cylinder should be standing by if needed. A clear
oxygen mask or hand operated resuscitator will be
attached to the oxygen unit.
Once the dental officer assesses the emergency, he
may direct a member of the team to notify the front