ENT emergencies Flashcards

1
Q

what can significant nasal trauma be associated with?

A
  • brain injury

- septal haematoma

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2
Q

how are septal haematomas treated?

A

drained in theatre

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3
Q

how can you tell if a lump in the nose is a septal haematoma?

A

-if its boggy and swollen

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4
Q

what can an untreated septal haematoma lead to?

A

-brain abscess

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5
Q

what is one of the most common emergencies seen in ENT?

A

epistaxis

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6
Q

what arteries are involved in epistaxis?

A

-internal and external carotid arteries

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7
Q

what is the management for epistaxis?

A
  • pinch soft cartilage of nose for 5 minutes at a steady pressure
  • may need to cautarise nose with nitrate
  • if this doesn’t work may need to pack the nose for 24 hours

If bleeding controlled:

  • arrange admission if packed/poor social circumstances
  • FBC
  • G&S

If bleeding not controlled:

  • arrange admission
  • FBC
  • G&S
  • consider arterial ligation (sphenopalatine artery, anterior ethmoid, external carotid)
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8
Q

what is the management for a patient who is really ill/ hypovolaemic with epistaxis?

A
  • resus
  • arrest/slow flow: pressure, ice, topical vasoconstrictor +/- LA (Lignocaine + adrenaline, Co-phenylcaine)
  • remove the clot using suction and nose blowing
  • cauterise using silver nitrate/diathermy and pack if you can
  • Tranexamic acid
  • take off anticoagulants/change
  • platelet transfusion
  • treatment for hypertension
  • correct clotting abnormalities

If bleeding controlled:

  • arrange admission if packed/poor social circumstances
  • FBC
  • G&S

If bleeding not controlled:

  • arrange admission
  • FBC
  • G&S
  • consider arterial ligation (sphenopalatine artery, anterior ethmoid, external carotid)
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9
Q

what are rapid rhino packs used for?

A
  • for ‘packing’ in epistaxis

- this can be very painful so may need analgesia on nose

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10
Q

what often causes a CSF leak?

A

-nasal trauma leading to a fracture in the cribriform plate

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11
Q

how long does it tend to take a CSF leak to resolve?

A

10 days

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12
Q

what is pinna haematoma?

A

cauliflower ear

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13
Q

what is the treatment for pinna haematoma?

A

either aspirate or incise and drain

if recurrent or big incise and drain (however this leaves a larger scar)

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14
Q

what is the management of lacerations?

A
  • Debridement
  • Closure (primarily if can)
  • Antibiotics especially if cartilage showing to avoid infection
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