ED 2 ENT Flashcards
what must you always be sure to do in PE of your child with otitis media?
examine/percuss mastoid
a displaced pinna and loss of posterior ear crease should make you worried about what? what can this progress to if not treated?
mastoiditis
can progress to meningitis, brain abscess, epidural hematoma
how do we treat mastoiditis?
zosyn, rocephin, or clindamycin
ENT follow up for hearing analysis
where are nosebleeds most common?
anterior kiesselbach plexus
if you pack someone’s nose after exhausting all other treatment options, how long do you leave it in for? what do you need to be sure to do?
2-3 days
force it STRAIGHT back and give ABX!
an immunosuppressed state + bad teeth put you at risk for what?
ludwig’s angina
what must you do STAT in your patient with ludwig’s angina?
crash tracheotomy! they have 50 percent intubation fail rate and cric is impossible
what two antibiotics do we give to ludwig’s angina?
PCN 24 million units
flagyl 1 gram IV
the haemophilus influenza unvaccinated child is at risk for which two ENT emergencies?
retropharyngeal abscess
epiglottitis
what will the lateral neck x-ray look like in epiglottitis vs. retropharyngeal abscess?
epiglottitis = thumbprint
retropharyngeal = prevertebral swelling
how will a retropharyngeal abscess present?
neck will look NORMAL
toxic, tripoding, drooling, muffled voice, stridor
how do we treat retropharyngeal abscess?
oxacillin or cephalosporins
maybe intubate
uvula deviation should make you think of what? how do you TX?
peritonsillar abscess
incision and drainage
pen VK if not allergic
why must you be super careful when draining a peritonsillar abscess?
you could poke the internal carotid
patient presents with a dental abscess, what should you do?
put them on ABX and then refer them to oral surgery (no dentist goes near them unless on ABX)
