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Multilingual Support:

Concerns

Signs and symptoms

Action

Signs and symptoms

  • agitation
  • weakness
  • headache
  • pallor, tremor, and palpitations
  • change – increase or decrease – ┬áin blood pressure and heart rate
  • muscle twitching and tremors
  • light-headiness
  • tinnitus
  • if too much lidocaine – possible decreased blood pressure, heart rate and respiration
  • skin eruption/hives
  • seizure activity

Action

Mild reaction
  • be calm and reassuring
  • discontinue dental treatment
  • clear the mouth of all foreign objects
  • assess responsiveness
  • evaluate breathing, airway and circulation
  • monitor blood pressure, pulse and respiratory rate every 5 min
  • administer oxygen, 6-8 L/min
  • allow for recovery
  • discharge only with escort or transport to hospital
Severe overdose

In addition to what is done during a mild reaction:

  • start an IV and administer midazolam 2mg, continue 1mg/min to achieve resolution (monitor respiration!)
  • activate emergency medical services (EMS)

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