When faced with an emerging perioperative medical event, the following hierarchical steps must be implemented in every situation: (1) assess responsiveness, (2) check airway, (3) and, simultaneously, check breathing and pulse (Box G). These fundamental activities comprise the primary survey (Box F), which identifies those problems that are immediately life-threatening and must be promptly acted upon, i.e., obstructed airway, respiratory arrest, or cardiac arrest.
Box G. Primary Survey: Every Patient.
Assess level of consciousness:
Look for breathing and check pulse (minimum 5 seconds; maximum 10 seconds):
The unresponsive patient in an oral healthcare setting depend on the office emergency team for (1) early recognition of airway obstruction, respiratory and/or cardiac arrest and activation of EMS, (2) early high-quality CPR to delay brain damage from lack of oxygen, (3) early defibrillation to restore an effective heart rhythm, and (4) early advanced life support and post-arrest care. For each minute CPR and/or defibrillation is delayed, the patient’s chances of survival is reduced by 7 to 10 percent.