ENT Emergencies Flashcards
What do you use to determine if nasal drainage is CSF or not?
halo sign- blood will stay in middle and CSF will go around it in a halo
Cause of septal hematoma
trauma to the anterior nasal septum
Complications from undrained septal hematoma
Saddle-nose deformity, Septal perforation, Septal abscess
Tx for septal hematoma
Drain and pack. Antibiotics (Augmentin) if abscess suspected IV Clindamycin and admission
Most common facial fracture
nasal fracture
Management of nasal fracture
closed reduction 2-10 days post injury to allow for reduction of swelling
Tx for auricular hematoma
Drain within 7 days, compression dressing, daily follow up for a few days, antibiotics to cover staph
Complicaiont from undrained auricular hematoma
cauliflower ear
Sx include hemotympanum, effusion, otorrhea, hearing deficit, nystagmus, ataxis, battle sign, facial nerve deficit
middle ear injury
Bone that is most commonly involved in basilar skull factures
temporal (75%)
Indicative of basilar skull fracture and middle ear injury
hemotympanum
Drops that are CI in ruptured TM
gentamycin
Test used to evaluate for bite in mandibular fractures
tongue blade test
Unilateral rhinitis, foul odor, epistaxis, pain
nasal foreign body
initial management of epistaxis
blow nose, spray with afrin, lean forward and pinch nares together for 10 minutes
What is next step if packing and silver nitrate sticks are unsuccessful at stopping epistaxis?
leave packing in place 48 hrs, follow up in 24-48 hrs.
T/F most patients who need posterior packing are treated outpatient
false, most are admitted. call ENT
Complication of frontal sinusitis or trauma characterized by osteomyelitis of frontal bone most commonly seen in kids and teens.
pott’s puffy tumor
Hallmark of 7th nerve palsy (Bell’s Palsy)
sudden onset
Prognosis of 7th nerve palsy (Bell’s Palsy)
80% recover to normal or near normal function
What should stitch with ear laceration and what should you not stitch?
Can do a single layer closure through skin and perichondrium but not the cartilage
bacteria involved with chondritis cellulitis
s. aureus and pseudomonas
bacteria involved with facial cellulitis
staph and strep
where can a retropharyngeal abscess spread to?
mediastinum
CXR finding with retropharyngeal abscess
expansion of the prevertebral soft tissues
Gold standard for retropharyngeal abscess diagnosis
CT scan
Tx of retropharyngeal abscess
IV hydration, IV abx (clindamycin or Unasyn), ENT consult, I & D
Etiology of ludwig’s angina
odontogenic 90% of cases (staph, strep and bacteroides)
PE shows bilateral submandibular swelling and protruding tongues
Ludwig’s angina
What should you avoid if there is a laryngeal crush injury?
cricothyroidotomy