Injuries to Eyes, Nose, Ears, Face & Throat - CH.26 Flashcards
at what depth/length of a laceration should you refer to a physician?
anything more than these values:
- 25cm long
- 3 cm deep
you come the corner of a side street and you see a person laying on the ground unconscious. Upon inspection, you see that there is apparent ecchymosis around the eyes and ears. There’s clear fluid coming out of their eyes and nose. As you palpate the skull is there’s an apparent divit. What should you expect? how should you mng?
skull fracture
check for ABCs - act accordingly if not present
if they are breathing/pulse/ airway is clear - stabilize Csp & call for EMS - tx for shock
an athlete with a concussion has no clue as to what happened prior to the injury, what is this term called?
retrograde
an athlete with a concussion has no clue as what happened after the injury, what is this term called?
anterograde
an athlete has been hit in the face by one their opponents, you ask them if they’re okay, but they “claim” to be fine. They then get nudged in the back and within a couple mins they start to deteriorate. What could be happening?
secondary-impact syndrome
an athlete has sustained a blunt force to their head. As you approach them on the field, you can tell they’re likely unconscious. They come to as you approach them. After talking for a couple of minutes, they seem to be doing fine. A couple mins later they start to deteriorate again. What do you suspect is happening? how to mng?
epidural hematoma - due to to the ludic intervals of being fine for a couple mins to deteriorating
Call EMS immediately - tx for shock & stabilize csp - depending on where you are (provincially), you may be able to collar and board athlete
what are the 3 types of subdural hematoma?
acute subdural hematoma (same as epidural hem. - common cause of death in boxers)
subdural hem. associated with other trauma to skull
chronic - occurs due to venous bleeding
what must you always suspect if there is an injury to the face?
a head injury
you’re at a rugby pitch and you are currently taping an athlete on the sideline. Another athlete runs up to you trying to tell you that it’s hard for them to speak and that they can’t feel their lower jaw. As you look at them - you see an obvs deformity at their jaw and feel slight crepitus. What do you suspect? how to mng?
mandibular fracture
use a triangle bandage to stabilize the jaw - call EMS - tx for shock if applicable
in a “tripod fx” what would you see?
all 3 sutures: frontal, temporal and maxilla are fractured
decreased prominence of cheek bone
what happens with a maxillary fracture (lefort fracture)?
when maxilla and maxillary teeth are completely separated from the skull
what are the 3 types of tooth fractures?
can an athlete continue to play if they continue to play?
- uncomplicated crown - part of tooth is chipped off (NO bleeding)
- complicated crown (bleeding occurs)
- root fx - below gum line
yes as long as there’s no excessive bleeding and there are no reasons to pull them out of play
how to store a person’s loose tooth?
in a plastic bag with saliva covering it.
refer to dentist immediately
after an athlete has had a nose bleed, what should they avoid post-game/event/ practice?
avoid blowing the nose for at least 2 hrs
how to mng cauliflower ear?
decrease the friction/shearing force on ears
wear ear guards
immediate application of ice pack (may need drainage from a physician)
one of your athletes tries to dunk, but then gets rejected from the other team. In the process of getting rejected the ball gets slapped back towards their ear. The athlete comes off holding their ear. When you try to talk to them they have to tilt their head the other way because they have a hard time hearing you with that ear. What might you suspect? how should you mng?
potential tempanic membrane rupture from the blow of the ball
rule out concussion - no RTP
s/s of otitis externa aka what?
swimmer’s ear - excessive fluid build up leading to infection
P/ discharge at ears
hearing loss
when assessing eye movements and tracking, what CN are you testing
CN III, IV, VI
perform the 9 cardinal planes of gaze
up L up up R left convergence right down R down down L
What test is used for visual acuity?
Snellen’s chart
2 methods to remove foreign bodies at the eye
pull upper eye lid over lower as they look down (promotes prod. of tears)
washed with saline solution
an athlete comes to you with blood accumulated in front of their eye - what is this condition called?
hyphema
refer to physician
a football player to comes to you on the sideline and is worried that he can’t see properly. They describe it as a “curtain” blocking their vision. What might you suspect?
retinal detachment - refer to MD
how to mng a stye?
hot compress to drain the oil gland
resolves within 4 weeks-ish
