Under what circumstances should EMS be called for a suspected anaphylactic reaction in the dental setting?

• A. Never call EMS.
• B. Only if the patient becomes unconscious.
• C. If symptoms worsen or a severe reaction occurs.
• D. Call EMS after 24 hours.

Answer: (C)

Anaphylaxis is a life-threatening emergency that can progress quickly, so emergency services should be summoned as soon as there are signs of a worsening or severe reaction. In the dental setting, this means if the patient develops or progresses to airway involvement (difficulty speaking or breathing, swelling of the tongue or throat), marked breathing difficulties, dizziness or collapse, fainting, or widespread shock symptoms like very low blood pressure, you should call EMS immediately. Early access to advanced airway management, IV fluids, oxygen, and medications is essential, and waiting for symptoms to become more dramatic can be dangerous.

While help is on the way, continue emergency management: administer epinephrine if available and appropriate, monitor the patient closely, place them in a safe position, and ensure someone is communicating with EMS about the onset and progression of symptoms. Do not delay calling for help because the person is still conscious or has mild symptoms, and certainly do not wait 24 hours before seeking urgent care.