All Emergencies - Basic life support principles:

1. Maintain an airway
2. Assess breathing
3. Monitor circulation

Management:

1. Terminate dental treatment.
2. Place patient in supine position.
3. A-B-C Airway, Breathing, Circulation - Basic life support, as indicated.
4. Monitor BP, heart rate & rhythm every 5 minutes.
5. Administer oxygen.
6. Start IV infusion if not already present.
7. Antidotal drugs can be used, though not usually necessary:
   • When opioids have been administered, give naloxone - adults - 0.1 mg/min until improved ventilation noted.
   • When benzodiazepines have been administered, give flumazenil - adults - 0.2 mg/min until improved ventilation is seen.
   • When barbiturates have been administered, no antagonist exists. Continue assisted ventilation until spontaneous breathing returns.
8. Recovery: It may be possible to continue dental treatment if respiratory depression was brief. If problem was prolonged, it may be necessary to end planned treatment.
9. Discharge the patient to a responsible adult if the doctor believes patient's recovery is adequate. Outside medical assistance rarely required.

Source: Sedation, A Guide to Patient Management by Stanley F. Malamed