ENT and Ophthalmic Flashcards
1
Q
What are the steps involved in performing a lateral canthotomy?
A
- Obtain consent and consider sedation/analgesia
- Sterile precautions, antiseptic (chlorhex or iodine)
- Infiltrate 2mls lignocaine into the lateral canthus
- Compress lateral canthus with haemostat (artery) forceps to reduce any bleeding for 1 minute
- Cut along lateral canthus approx 1-2cm with scissors towards orbital rim
- Retract lower lid down and strum inferior crus of the lateral canthal ligament
- Cut through inferior crus with the scissors, confirmed by freely mobile lower lid and no tendon strummable with forceps
- Reassess eye for improvement in VA, IOP and resolution of RAPD (typically takes 15mins)
If not improving can consider cutting the superior crus as well, but not normally done
2
Q
How is a ring block of the ear performed?
A
Indication
- External ear procedure ie drainage or suturing
Procedure
- Consent and analgesia
- Prep and drape
- Lignocaine/Ropivicaine 10mls
- 25g needle
- Inferiorly start in line with the tragus 1-2cm below the ear, aim just anterior to the tragus and then towards the mastoid, inject 2-3mls both sides
- Superiorly 1-2cms above the ear, aim anterior to the tragus and at the mastoid process
3
Q
What are the steps involved in repairing an ear laceration?
A