Ears MDT Flashcards
What is auricular hematoma?
Accumulation of blood in the subperichondrial space, secondary to blunt trauma
What can auricular hematoma result in?
Cauliflower ear
What will you find on physical examination of Auricular Hematoma?
Loss of landmarks
Separation of perichondrial blood vessels in auricular hematoma can result in what?
Necrosis
How should auricular hematoma be treated?
- incision should be made not to violate perichondrium
- incision should be on inner curvature of helix or antihelix
What should be done after auricular hematoma drainage?
- Splinting of ear
- Apply Neosporin BID
How should live objects be dealt with in the ear?
2% lidocaine solution to drown them
Sx of ear foreign body
- specific MOI
- muffled sounds
- severe pain
- hearing distrubances
What temperature should water for ear irrigation be?
Room-temp
What equipment can be used to assist in ear foreign body removal?
- cerumen loops/scoops
- right angle alligator/alligator forceps
If you cannot see the TM, should you still irrigate?
No, unsure if TM is perforated
What are some c/c of patients with cerumen impaction?
- decrease hearing
- sensation of pressure or fullness
What worsens cerumen impaction?
Q-tips
What equipment can you use for cerumen impaction?
- Loops and scoops
If irrigating the ear, what is the procedure?
- 18 gauge IV catheter
- Body temp water
- irrigate along superior portion utilizing pressure of stream to help break up/dislodge impaction
What medication can assist cerumen impaction?
Carbamide Peroxide (Debrox) 2-5 drops BID for max 4 days
What is a common injury after ear irrigating?
TM Perforation
What is mastoiditis?
Mastoid cavity becomes a closed space after a blockage occurs
Mastoiditis is normally a complication of what condition?
Otitis media
What will you find on physical examination of mastoiditis?
- Post auricular pain, erythema with spiking fever
- obliteration of post auricular crease
- protrusion of the auricle
What radiologic studies should be done with mastoiditis?
- Mastoid radiography
- CT
What lab should be done with mastoiditis?
Culture of drainage
Medications for mastoiditis
- Ceftriaxone
- Levofloxacin
- Cefazolin
What should be done with mastoiditis after MEDEVAC?
- Admission
- I&D
- possible mastoidectomy
What is otitis externa?
Diffuse inflammation of external ear canal with or without inflammation of auricle and/or TM
What are most common organisms associated with otitis externa?
Staphylococcus (10-70%)
Pseudomonas (20-60%)
Findings leading to otitis externa?
- purulent exudate
- hx of recent water exposure or mechanical trauma
What lab should be done for otitis externa?
Gram staining of discharge
How should you dry otitis externa?
50/50 mix isopropyl alcohol/white vinegar