Medical Emergency in the Dental Practice 2025 – Early Warning Signs – SCRPS

So, let’s unpack the mnemonic to figure out quickly that a medical emergency is developing. This is so important that the Cynergex handbook has had its first page changed to reflect SCRPS as the first step in medical emergency decision making.

SCRPS (Adults)

Skin condition: Pale, cold and sweaty

Conscious: Unconscious, confused or agitated

Respiration Rate: Above 25 or less than 10 breathes in 10 secs

Pulse: Above 100 or less than 50

SpO2: Saturation of Oxygen in the blood using an oximeter – below 93%

Let’s go through some examples:

Fainting

Fainting is a brief episode of unconsciousness caused by a sudden drop in blood pressure. The most likely cause of this sudden drop will either be some change in the blood vessels or the heartbeat itself.

Blood vessels continually adjust their width to ensure a constant blood pressure. For instance, the vessels constrict (tighten) when we stand up to counteract the effects of gravity. Temporary low blood pressure can be caused by various events that prompt blood vessels to dilate (expand), including extreme heat, emotional distress or pain. The lack of blood to the brain causes loss of consciousness.

So, let’s look how SCRPS applies here.

The symptoms of a faint include:

• Pale face, Perspiration – Skin condition
• Light-headedness, Nausea, Collapse, Unconsciousness – Conscious
• Heightened anxiety and restlessness – Respiration Rate above 25 breathes
• Dizziness, Collapse, Unconscious – Respiration Rate less than 10 breathes
• Heightened anxiety and restlessness, Nausea – Pulse Above 100
• Light-headedness, Collapse, Unconsciousness – Pulse less than 50
• Light-headedness, Dizziness, Collapse, Unconsciousness – SpO2 – below 93%

Response

However, after lying the person down the flat, the unconsciousness lasts seconds and a full recovery after a few minutes.

However, we need to continue to monitor!

The next flip page after fainting is hypoglycaemia.

Going to the dentist for some people can be stressful. This causes the body to release hormones to cope. Adrenaline is a stress hormone that causes a rapid rising of blood sugar levels, this triggers an insulin release that drops the blood sugar levels, and in turn causes hypoglycaemia. The person then “falls into a heap”. Hypoglycaemia can both cause the stress and be the result of stress.

So, what happens is a complicated faint.

There is still:

• Pale face, Perspiration – Skin condition
• Light-headedness, Dizziness – Conscious

Response

Give the patient sugar, such as Glucose, Orange Juice.

If a full recovery does not happen call an ambulance.

If the patient then becomes

Unconscious – Respiration Rate less than 10 breaths in 10 secs

START CPR, SET UP DEFIBRILATOR, CALL AMBULANCE.