Emergencies

Question 1

Where does bruising and swelling typically present in nasal trauma?

Answer 1

Black eye

Question 2

What is the most important thing to exclude with nasal trauma?

Answer 2

Nasal septal haematoma

Bruising separates perichondrium away from nasal septum -> lose of blood supply to septum

This can lead to infections in danger triangle of face and necrosis of septum

Question 3

What blood vessel most typically causes epistaxis

Answer 3

Anterior ethmoidal artery

Question 4

How is epistaxis managed?

Answer 4

Pinch nose just below nasal bone - hold for 5-10mins

Ice

Question 5

What are the 2 steps to managing epistaxis in clinic?

Answer 5

FIRST remove clots and get area as dry as poss

1. Cauterise vessel w/ silver nitrate
2. Nasal packing (horizontally along nasal floor)

Question 6

What should be done about CSF leaks?

Where is the most common site?

Answer 6

Usually settle by themselves

Don’t immediately prescribe ABs - wait until meningitis appears if it does

Cribiform plate of ethmoid bone

Question 7

What is a battle sign?

What kind of fracture is it associated with?

Answer 7

Brusing which appears on mastoid behind ear

Temporal bone fracture

Question 8

How does a nasal spetal haematoma present?

Answer 8

Sensation of nasal swelling

On examination a bilateral red swelling
BOGGY on touch