I thought I'd share this latest opinion piece by a young dentist in the latest BDJ, entitled:
"Defensive dentistry and the young dentist- this isn't what we signed up for."

Read it here 

So what are THE main problems here in Dentistry in England worst of all, but relevant to all the UK too?

My shortlist would be:

1. An impossible UDA NHS contract that publicly promises unlimited care for needs, in a very limited system

2. Onerous regulation using the slide-rule of 'perfection' instead of 'seriously below' reasonable standards.

3. An increasing Claim/Blame culture that takes little or no SELF responsibility for prevention or resolution in the first place. It's like they are given an 'exemption' ticket and thus can claim/blame/complain with impunity, even when fraudulent.

4. A CLAIMS culture driven by some enhanced-fees Lawyers selfishly, resulting in the UK having the worst reputation in the World for FALSE or exaggerated claims, just to get free easy money, from car whiplash claims to holiday insurance etc.

5. Some very Poor Expert witnesses who seem to readily use a yardstick of perfection, without the experience or TRUE NEUTRALITY to act in the public interest first, regardless of WHO engaged/paid them and not applying No.2 above properly.
The trouble is those prosecuting/claiming are only too happy to send MORE work to those who seem to write the worst reports - this may be SO bad that it needs a lookback exercise - if it's good enough for our dental records then why not ?

5. Some indemnity organisations feeling vulnerable because of the above and/or struggling to put up a timely/full defence, make a Corporate decision to minimise THEIR future liabilities in years to come and payout early. It's a tough call for them I know, but many now want to see more pushback and earlier payouts may be just pouring petrol on the fire and thus encouraging more claims, fishing and efforts to get more payouts. It's like a feeding frenzie and that's bad for all.

6. Due to pressures and cuts from the DH and HEE on the undergraduate curriculums, clinical teaching is downrated and research and other targets get all the qudos/funding, so our Undergraduates are getting less clinical exposure, training and preparation for the 'real' world = more like walking into a Gladiator ring and surviving the first few years, but with early scars already from the above. Increasingly even after FT/VT not all are surviving those first few years after qualifying and already experiencing GDC, Lawyers letters, Complaints, Compromises from systems and Corporate limitations and high stress etc - certainly not looking forward to a happy Career!

7. Our Profession - yes we must take some of the blame, but currently we are taking ALL OF THE BLAME whilst Society is overlooking or even encouraging further the above 5 aspects for short-term gain and anyway those Dentists have it easy so let's see them suffer, right ?!? 

So at what stage do we reach breaking point - at what point do we say enough is enough and start acting together in Unity.???

UNLESS we start making it someone else's problem, this will continue and in 10 years when our Profession is decimated and dental care is so defensive it's do nothing or refer for extractions, the population suffers greatly.

Read that article again in the BDJ - our young graduates are rightly saying, this is NOT what I signed up for .

Tony Kilcoyne.

1. A. Al Hassan.  Defensive dentistry and the young dentist – this isn't what we signed up for. BDJ 223, 757–758 (24 November 2017)
2. M Kelleher. State-sponsored dental terrorism? BDJ 223, 759–764 (24 November 2017)
3. Discussion on GDPUK forum 

Image credit - hierher under CC licence modified

Last Monday 14th August 2017, I had another meeting with Jonathan Green (Head of FtP) and Matthew Hill (Head of GDC Strategy). 
It was a no holds barred meeting and I was free to ask any questions. I wasn't locked in dungeons under 37 Wimpole Street at any point! 
Here is the agenda of the 90-minute meeting, along with the GDC answers in blue. 

It raises some important considerations about what we need to do as a Profession. I think we need to think about the answers and discuss a strategy for the Profession. 

LISTERINE® Professional is now offering a variety of programmes focused on the most important topics facing dental professionals, including prevention strategies and patient communication.

• The LISTERINE® Professional Newsletter: A once-monthly e-mail to keep you informed on how to help patients treat or prevent common oral care conditions like gingivitis and sensitivity, or how to help prevent cavities.
• THE HABIT CHANGE CHALLENGE: An interactive learning programme to help you influence changes in patient behaviour even more effectively

By signing up for both or either programme(s) today, you will gain access to:     

• Clinical data that you can apply to your practice
• Tips on how to increase patient adherence to your recommendations
• Free LISTERINE® samples for you and your patients
• Information on upcoming conventions and events
• LISTERINE® product information and news

SIGN UP TODAY

We all know what fight or flight means. We all know the situations where you feel the rush of tension before you panic and go one way or the other.

The third response, freeze, is often overlooked. But freeze is exactly what I did, day in, day out, for years.

I froze. Standing, at the counter in my local big name coffee shop, for what felt like an hour. In reality it was only a second. What had caused this rush of fright?

The barista repeated. “Do you have a busy day?”.

That was it.

This wasn’t in my mentally rehearsed plan. I was ordering a cappuccino, the same as I did every Thursday in the morning, part of my weekly coping strategy. Going out of the house, doing SOMETHING, was better than sitting at home, waiting for the afternoon shift to start. I had become accustomed to going to the coffee shop, ordering the same thing every week, and gradually became more and more comfortable with my surroundings. And then this happened. I couldn’t go back. Well, at least not for a long time. I was comfortable, and she had ruined it by asking a straightforward question that any reasonable person would have answered without hesitation.

Social anxiety is a problem I’ve had since I was 8. I don’t remember exactly how it happened, but I was never really comfortable around people. Having someone who was obviously uncomfortable around other children drew the bullies out like flies to a turd. So I was a very obvious target of bullying. I froze, all the time. I couldn’t do anything. It got worse and worse, every time I was asked anything by an authority figure, I ground to a mental halt, unable to answer and unable to move. Rabbit in the headlights.

I was pushed into social events by my parents, who were clearly at their wits end and thought that forcing me to go to interact with other people would help. It didn’t. It made things worse.

As a teenager I got great solace in music. The louder the better. By putting earphones in, I could block out the cacophony of the outside world, and if anybody tried to talk to me, the brief time it took to take the earphones out gave me a fraction of a second to steady my nerves.

And then I discovered alcohol. I went to university, unable to feel comfortable when surrounded by anybody, and I found that at first beer took the edge off, then it became whisky. At the same time, I started smoking cannabis. Cannabis was wonderful. My anxiety was gone, I could be much more “myself” and it even allowed me to sit in a room and have no nerves at all.

But illicit drugs and alcohol soon took their toll and were starting to take over my life, as I descended down the path of alcoholism, and being so anxious of normal life that I couldn’t function without the instant and total relief brought on by cannabis.

I decided to stop everything. I stopped drinking, I stopped smoking cannabis. I was left (briefly) with the one drug that provided any form of relief, nicotine, although I stopped that fairly soon after.

Meeting new people was always very tough after that. It went back to how it was when I had been at school. I completely froze. When you freeze and struggle with conversation, people make all kinds of assumptions, with the stories sometimes making their way back to me through friends. If only they had known the truth, I don’t think people would have been so judgemental. The worst experiences were when people talked ABOUT me, to a third party, when I was right in front of them, on one occasion telling the third party that I was “the weirdest person I’ve ever met”, and the other, that I had “zero personality”. That was a trigger for a complete meltdown, and when it happened I struggled to leave my flat for a couple of weeks afterwards on each occasion.

And so on to the world of work. Eye contact became increasingly difficult. I somehow managed to develop a different persona for dealing with patients, and could blag my way through. I was able to talk to patients with comparative ease, but I always kept it very informal. Staff, however, were almost impossible to deal with. The more people tried to assert themselves as an “authority figure”, the worse it became. I once again got labelled as “weird”, got left out of social events, and then told that I made no effort to socialise. I do wonder if they knew how much effort it was to smile and say “Hi” to somebody in the morning, whether the same judgement would be made.

I recently decided to get treatment for this as I was incapable of living a normal life. It’s a lonely existence, plodding through life without any real social interaction. Social media has equally helped and hindered me at the same time, in that while providing an outlet for at least some socialising, it has also acted as a crutch, and got in the way of normal social interaction.

I had 8 sessions with a psychotherapist to try to overcome the social anxiety, and while progress is slow, the realisation that nobody looks or cares about me or what I say, was actually a huge relief. My GMP prescribed some antidepressants that unfortunately made my anxiety worse. However, after nearly a year of pushing myself into more and more uncomfortable situations, I’m much better. I can finally look somebody in the eye, and I don’t freeze when the conversation goes “off script”. I don’t take any medicines and I am no longer receiving any psychotherapy.

My only regret is that I hadn’t been able to access the treatment earlier. 

Image credit -PracticalCures under CC licence - not modified.

Mike Cann, Managing Director of Septodont Limited, has been elected President of the British Dental Industry Association (BDIA).

Mike, who has 30 years of experience in the industry, comments, “I am delighted to have been elected as the new President of the BDIA and look forward to working closely with my fellow Councillors and the staff and members of the Association to build on the strong leadership that the organisation provides.”

He adds, “I am particularly keen to encourage everyone involved in dentistry to maximise the benefit derived from attending the UK’s premier dental event, BDIA Dental Showcase, and to ensure that the Association is leading the industry from the front, while delivering the best possible services and initiatives for all our members”.

Mike was elected at the BDIA’s recent AGM held at Danesfield House, Marlow and takes over from outgoing President, Terry Porter. Sonia Tracey, Managing Director of W & H UK was appointed as Vice- President, and Peter Gowers, Managing Director of Panadent, was re-elected as the Association’s Honorary Treasurer.

The digital workflow has brought with it a great many advantages to modern dentistry including enhanced communications between practice and lab.

CS Solutions from Carestream Dental offers all of these benefits, as practices using the innovative system are able to send you more comprehensive and accurate instructions for any and all work requested.

You’ll simply receive an open STL file from your client containing all the information you need within minutes of them sending it. This means you can even discuss a case while the patient is still in the dental chair, ensuring enhanced collaboration for exceptional treatment outcomes.

What’s more, it costs you nothing to work with practices operating with CS Solutions – you needn’t purchase any new software or pay for any upgrades at any time. You simply need any open CAD or CAD/CAM system in place, and that’s it!

So regardless of the complexity of a case, you and your clients can trust CS Solutions to help you achieve the very best results for every patient.

For more information, contact Carestream Dental on 0800 169 9692 or visit www.carestreamdental.co.uk

The CS 8100 OPG unit from Carestream Dental offers a perfect blend of simplicity and sophistication. Designed to produce the highest quality images in the shortest amount of time, the CS 8100 delivers crystal clear, optimally exposed images in seconds.

Dr Robert Watson of Dollar Street Dental uses the CS8100 in his practice, he says:

“Our new CS81003D has really transformed the way we diagnose and treat our patients. 

“We are a general practice with a special interest in implants and endodontics. Both procedures are transformed by having the ability to view the proposed treatment in a 3D image. There is no steep learning curve when using the machine and the huge benefits are instantly available for both clinician and patients. Well done Carestream for bringing quality panoral and CT scanning to the general practitioner at a cost that makes sense.”

If you are looking to advance your treatment workflows with cutting-edge imaging technologies, contact Carestream Dental today.

For more information, contact Carestream Dental on 0800 169 9692 or visit www.carestreamdental.co.uk

Thursday 16th April 2015 is the day I will never forget.  I was in surgery with Amy.  Bea was at reception.  It was a life changing moment for me and I am sure, for all of us, by Dr Chris Tavares BDS

THE CARDIAC ARREST

We were ready to get the patient in.  At around 3:45 pm,  Amy went out to get him in.  As the surgery door opened I could hear him having a laugh with Bea.  He came in, we exchanged the usual superficial pleasantries, had a laugh.  Asked him how he was. He said “Fine, very well thank you”.   Soon, was this to change.

He told me he had fractured a tooth in the upper right area this morning. There was no pain but it was sharp.  I turned round to type this into the clinical notes.  I could see that his ASA rating was 1.  Nothing medically to worry about.  As I was typing, I heard heavy breathing behind me.  I turned round and saw his eyes had closed, his right leg was hanging off the side of the dental chair and as I faced him, calling his name and shaking him and lightly slapping his face, the breathing became more laboured.   I lowered the chair back right down and called him again.  Suddenly he came round and said: “Yes, yes I’m ok”…and then….he was ‘gone’ again. The breathing became more laboured to an alarming level. 

I asked for the emergency kit and Amy came back with it.  He was still breathing heavily.  As I attached the pulse oximeter to his finger, his head suddenly came forward, tongue protruded and his breathing become a desperate stridor.   His face then went completely purple / ashen. 

Immediately I instructed Amy to let reception know “Medical Emergency.  Cardiac Arrest. Call an Ambulance.”  She went straight outside.  I noted the time and started CPR immediately.  30 compressions to 2 breaths.   At one stage, I vaguely remember thinking part consciously, that If I don’t do this, he will die. It was a battle between death and I and death was not going to take him, not on my watch.  I pumped like mad.

I heard Bea, shout, if he was breathing. I shouted back: “No. Cardiac arrest. Not breathing.”  

Amy came back in and brought the AED in. We connected it up and followed the instructions.  Bea stayed on the phone in, in case 999 needed to speak to her.

The AED spoke in an incredibly loud ‘voice’:

“Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the whole chest arched and lifted off the chair with part of his body.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

Meanwhile as Bea had more training in Med Emergency, she came in and Amy went outside to wait for the ambulance.  As I carried out compressions, the pulse oximeter showed a pulse of 110  and oxygen content of 70%.   This little bit of information was reassuring as our AED did not have a screen with the ECG tracing. 

The AED instructed again:  “Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I followed the instructions.

The first paramedic arrived. This was about 11 minutes from the time the patient went into cardiac arrest.   I continued CPR.  He took over immediately to check the back of the chair was firm enough and immediately said ‘yes’, good.  I then took over again as he got his gear out.

The AED instructed again:

“Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the chest arched and lifted off the chair.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

Suddenly the patient responded and pushed my hands off his chest!  Then went still again.

The paramedic was in no hurry to attach his AED.  He asked if our AED showed what was happening on a screen.  I said no.  He seemed happy to continue with our AED at the moment.

The AED instructed again:  “Stand back. Do not touch the patient.  Assessing rhythm…..Shock advised…….Press the red button and shock.”  I did this and the chest arched and lifted off the chair.  The AED assessed the rhythm again and instructed us to continue to carry out CPR. 

By now two more paramedic vehicles and the ambulance had arrived.  Literally minutes if not seconds, 4 more paramedics came into the surgery.   The lead paramedic, the first one who arrived, switched over to his AED which had an ECG tracing.   The second lead asked about the medical history of the patient and I informed him it wall all clear. 

The third paramedic took over external cardiac massage as the second put an IV line in.  Sugar level was tested. Negative.

It is difficult to recall exactly what happened when and what was done when and in what order.  An airway was put in.   A drip was set up.  At some time I think they also injected something.  They did other things I am not sure what.  They also attached a contraption that carried out external cardiac massage.

As they looked at the ECG I heard the second paramedic say to the lead, “That’s VT” (I think that’s what he said. There was definitely a ‘V’ in his sentence) and this was confirmed by the first.  Everyone was instructed to stand away from the patient, they pressed a button, you could hear a ‘whine’ as the defibrillator charged and they shocked the heart again. 

The ECG tracing went flat and suddenly started up again and I could see what appeared as a more ‘normal’ tracing.  Then it took on another pattern again. 

They were in the surgery for about 1 hr to 1 hr 30 mins.  The tracing on the ECG was erratic and inconsistent in that time.  Every time they shocked him, the line went flat and then started again.

I had to help to deliver the oxygen for a few minutes.   In total the patient’s heart was shocked 6 - 7 times.

I am sure he had ‘come’ round a few times in that 90 minutes.

After the last shock, I cannot say exactly when but I suddenly realised they had stopped the compressions and delivery of oxygen.   They were moving around more relaxed. The lead paramedic asked one of the ambulance drivers to bring something in.  Then he asked her to bring the stretcher in.  I thought: “What, is he…dead?”. 

I had forgotten about the ECG.  I suddenly remembered it and looked over at it…..even though the patient was unconscious and no obvious signs of life, to me, ……… there was a ‘normal’ heart tracing on the ECG.   Very regular and steady.  I looked at his chest…he was breathing on his own!  I thought: “My God, there’s a normal rhythm!”  

They lifted him onto the stretcher with the airway and ‘automatic cardiac massage’ contraption still in place, I think. The airway was definitely in.   I suppose in case he needed it again.

3 of the paramedics went with the patient to the hospital, having taken the patient’s personal details.  2 stayed behind to pack up and clear up.  I asked the second paramedic if the patient was OK.  He looked at me, looked at our AED the oxygen cylinder and said pensively:

“He’s OK. Will have to see if he pulls through.  Hopefully there is no brain damage.  You got the oxygen,…. (he looked at the AED again, which was lying on the surgery floor) …….you had the defib…….you saved his life.” He said nodding.   It had not dawned on me at the time the significance of what he was saying.

The two remaining paramedics left, saying that they’ll be back to pick up the last remaining paramedic vehicle when they’ve finished at the hospital.

THE IMMEDIATE AFTERMATH

The three of us sat down, numb and started talking about the incident.  Bea made cups of tea and we sat in the staff room.  We agreed we could not have done anymore.  When he had been put into the ambulance, Amy said she heard one paramedics say to another that the patient had pulled the airway out.  This was put back in then the doors were closed. So it was good, it was reassuring to know that he was alive when he left the surgery to be taken to the hospital. 

There were no elation and shouts of joy. Just numbness.  The shock and disbelief that we had just be part of and witnesses to a full blown cardiac arrest in our dental chair.

As Amy and Bea were talking, I remember I had asked one of the paramedics if there was something we should do or someone we should report to. He said there was nothing.  If the patient dies, the police will be round to make their enquires and investigate.  If he pulls through, we probably won’t hear from anyone.

When I look back now, I cannot help but feel what a sad and unacceptable and ridiculous situation the profession has been put into by those who have the authority to ‘rule’ over us but really have been given or taken more authority that they deserve.  I have been told by a paramedic that we did the right things and possibly saved someone’s life, at the moment, but instead of elation at a professional stance of doing the right thing, unfortunately I started worrying about whether I had all the right ‘paperwork’, dotted all the ‘i’s and crossed all the ’t’s if there was an investigation!

When we finished our tea and I could see we were alright, we went down stairs to tidy up.  Bea put a note to order a new set of adult pads for the defibrillator.  I checked the oxygen content whilst Amy put the Medical Emergency things away.

It would have been about an hour to 90 mins when the door bell rang. Paramedics 1 and 2 were there.  We looked at them holding our breaths.  I asked how the patient was.  The lead said, looking at the ground:

“We have some news for you.  Looked up and smiled. We have him up and talking.  He’s actually up and talking.  He must have had a massive blood clot in the artery. They are thinking of discharging him in a few days. Well done” as he looked at each of us.

The relief from the three of us was palpable in the air.  He’s OK!

The 2nd paramedic looked at the three of us, then at me in the eyes and said something about CPR, getting the oxygen in then…..

“You had the defib…….YOU SAVED HIS LIFE””, nodding and repeated as he looked round at the three of us: “you saved his life, well done” and smiled.

I thanked them for delivering the good news, thanked them for getting here so quickly and for all they had done.

The two then left.

We shut the door and elation!  The total release of suppressed, involuntary tension.  Earlier on once the paramedics had arrived, Bea had cancelled the rest of the patients for the day and evening. I felt they deserved to have the rest of the day off!  Fortunately we weren’t seeing patients the next day.  They went home.

I stayed behind for a bit.

PERSONAL REFELECTION

Bea and Amy were just great.  I could not have asked for better support.  This was the first, and last I hope (!), medical emergency we had to deal with and, for all that, in at the deep end.    Amy just carried out unquestioning what she was asked to do.  Bea, calmly called the ambulance and handled the reception area.  In fact, as Bea was cancelling one of the patients’ appointment, he commended her on how calm she was when talking to him, given what she was in the midst of.

We were lucky there were no other patients in then.  No one ‘collapsed’ , broke down in tears or freaked out.  They both held it together.  Just amazing.

I will forever be grateful for the regulation that insisted we had Continual Professional Development (CPD) on “Medical Emergency” every year.  Every year we had a hands on 3 hours training session and I would also attend an additional lecture session.  I was never sure how much of this I actually retained in my head.

I made sure we held a medical emergency drill once a month. Only I knew when I would call one. I would always choose a time so we had a different number of staff around. We may miss a month at most but we held the drill regularly.

I am in no doubt this was one of five things that affected the outcome.

INSTINCT

When something like this happens, there is no time to think, no time to work your way through some mental venn diagrams or following the boxes of a mental flowchart.  It had to be instinct and what was already in your subconscious. 

Everyone just went into action. Everything just went so smoothly.  The call for the ambulance. Staying online with the 999 operator. Waiting outside for the ambulance.  Amy saw him and made a beeline for him.  CPR: 30 compressions to 2 breaths.

I have no doubts the regular drills helped us all.

STRIDOR & SUBSEQUENT LOSS OF COLOUR

I did not have to work out if he was breathing or his heart was beating. This just told me …negative.  I was lucky to have had these signs.

I just started immediate CPR and the ambulance was called. 

The rapid response I am sure contributed to the outcome.

CARDIAC COMPRESSIONS

One can never know if one is compressing chest deep enough.  You can’t measure the depth of compressions in such situations.In this case the colour of his face instructed me.  I could actually see the colour come back to his face.   This helped a lot when one is not consciously in a thinking mode and operating on instinct.

AUTOMATIC EXTERNAL DEFIBRILLATOR

The enemy to anything we do …….is ‘doubt’.  If you start asking yourself, doubting your actions, for anything, it is a recipe for disaster or failure.

He was, as I came to know, in VT/VF. I have no doubts the AED contributed to the positive outcome, directly and INDIRECTLY. 

Before the AED was connected, I was just pumping away but no idea if it was helping. 

The question always in the back of my mind is if I’m doing the right thing at the right time. 

When I connected the AED up, the minute I heard its “voice”, I was immediately aware of a sudden mental, physical and emotional relaxation. It was like having the consultant cardiologist in the surgery.

“Stand back…do not touch the patient…assessing rhythm….shock advised….press the red button and shock.”  I just thought: My God, his heart is being monitored now.  “Somebody” knew what was going on.  There is nothing more to do but follow the instructions.  It had an immediate calming effect on the whole process.

I had wondered if I should buy the AED.  I did. We’ve had it for 5 - 6 years now, every day checking the “green ready” light is on, never once thinking we will need it.  I have absolutely no regrets in buying it. 

I am well aware that there is still going on a major disagreement amongst professionals whether the AED is necessary in the dental surgery.  I will have no hesitation now to say YES.  I cannot be more appreciative of the AED.  It made the whole incident so much more easy to handle and I will forever be grateful we had one.  It actually helped to calm the room.   Was it ‘the thing’ that saved his life?  I don’t know.

I remember hearing at a lecture on Medical Emergencies.  I cannot remember who it was.  What he said was that we can never fully know exactly what is happening to the heart muscle and how it will respond to anything we do.  The patient, to all intents and purposes, is dying or nearly dead. If there is anything we can do that will remotely contribute to a positive outcome….DO IT.

Of course there is never absolute certainty in life.  The consequences of our actions can never be fully predictable.  If one will only act if one is always absolutely certain of the consequences of one’s actions, then one would just sit and do nothing.

The AED contributed in two major ways:

1    It really calmed the room whilst we waiting for the paramedics to arrive.

2    As I saw on the ECG screen later, it gave the heart a chance to re-establish a normal rhythm.

I HAVE ABSOLUTELY NO DOUBTS THE AED CONTRIBUTED TO THE POSITIVE OUTCOME in this case.

LUCK

Pure luck had a lot to do with it.  We were lucky the paramedics were able to arrive so quickly and there were so many.   They were just amazing.  They went about what they had to do in a calm, confident and controlled manner. 

We were lucky, before the paramedics arrived, none of us freaked out.  I have no doubts the regular drills we had played a large part.

One can never say for sure what exactly it is that brought about the positive outcome but I am sure luck played a part in it.

WHERE AM I NOW?

There is the disbelief that I was actually  deep in the middle of it all.  I actually looked at the face of someone who was clinically dead and he pulled through?   I came back from the Dentistry Show the day after ‘the event’ and went straight to the surgery, to call the hospital to see how he was. There was a slight eerie feeling going into that empty building, into the surgery. It was all clean, tidy and quiet. I could not help but wonder if 24 hours earlier, did all that really happen?

The suddenness of it all is what is so frightening. There were no medical history concerns.  One minute he was there, two minutes later he was gone. If he had been in his car, 5 minutes late for his appointment, he would have had it in the car and could have ploughed into a bus stop with men, women and children.

I value my life much more now.  An appreciation of what I have, life, wife and children,friends and who I am.  So much we take for granted. 

I was surprised how well we all were when we attended to patients two days later.  It will take some time for the slight apprehension to dissipate.  Is this person going to suddenly have a heart attack on me?

The recent developments, all the nonsense, in the dental profession had really got me down.   All the effort in having to keep a surgery running with all the nonsense regulatory compliance and then having more piled on, unnecessarily.  I had been tired of putting so much effort into working as a dentist and getting so little back in return as the pressure of legislature piled on.  I was tired of legislature getting in the way of patient care. 

This ‘event’ has helped me to see things in perspective. This has been a good boost in morale as at least, all this effort came to fruition.  I am very proud of my staff and I hope they are of themselves too.

There is a mixture of emotions or feelings in myself.  Of course there is an immense feeling of gratefulness that we had a positive outcome.  Then, there is the feeling that one has been in a ‘privileged’ place, if that’s the word to use.  To have been involved in the thick of things and have a positive outcome.  Then there is something else I am aware of.   I am not sure how to describe it but it is a good feeling……….there is a deep seated feeling of stillness.

Every so often, the words that still ring in my ears:  “You had the defib……you saved his life.”

That inner stillness…..is….good.

Chris.

Dr Chris Tavares,

Dental Practitioner, Derby

April 2015

This blog was first published in April 2015, a few days after the event. In May 2016, after seeing more data, Dr Chris Tavares added the following:

I wanted to correct a few inaccuracies so as to be fair to the East Midlands Ambulance Service who did such a fantastic job on the day and to give credit when and where credit is due.

In the heat of things, a second can seem like a minute. A minute can seem like three minutes. I was able to download the data from the AED which records an ECG tracing every second. The AED analyses the rhythm every 2 minutes and advises to shock or not.  I was able to work out the exact timeline from this.

The heart was in VF.  CPR was started within 10 seconds of cardiac arrest.  The first shock to the heart was within two minutes of cardiac arrest.  The first paramedic arrived 5 minutes from the time we dialled 999. The five paramedics were in the surgery for about half an hour when a normal heart rhythm and spontaneous respiration were re-established and the gentleman was taken to the hospital. 

I have no doubts the rapid sequence of responses added to the positive outcome.

 The whole situation can best be summed up:

 “We did what we had to do ... the paramedics did their magic ... and the hospital staff performed the miracle.”

The gentleman is alive and leading a full life, no brain damage, no external scars.

Buy an Automated External Defibrillator and save a life.