illinois emsc1 eent and dental objectives upon completion of this lecture, you will be better able...
TRANSCRIPT
![Page 1: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/1.jpg)
Illinois EMSC 1
EENT and Dental Objectives
Upon completion of this lecture, you will be better able to:
• List the steps in assessing an eye injury• Describe interventions for specific eye injuries• Identify school activities that place students at risk for eye
injuries• Evaluate the severity of an emergency involving the ears,
nose or throat• Describe signs that indicate pathology of the oral cavity• Identify dental, oral and maxillofacial trauma and describe
appropriate interventions
![Page 2: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/2.jpg)
Illinois EMSC 2
EYE EMERGENCIES
![Page 3: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/3.jpg)
Illinois EMSC 3
SPECIAL CONSIDERATIONS
• Eye injury - suspect head injury
• Loss of vision is traumatic
• Great anxiety
• Contact lenses
• Transient signs and symptoms
![Page 4: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/4.jpg)
Illinois EMSC 4
FOCUSED ASSESSMENT
• Visual acuity
• External Inspection
– Lids, lashes, conjunctiva, and cornea
– Symmetry of eyes
– Eye movement
• Palpate orbital rim
• Pupils
![Page 5: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/5.jpg)
Illinois EMSC 5
Eye Anatomy
![Page 6: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/6.jpg)
Illinois EMSC 6
EYE ASSESSMENT
Current History
– Mechanism of injury
– New or recurrent problem
– Loss/change of vision
– How does the eye feel?
![Page 7: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/7.jpg)
Illinois EMSC 7
Selected Eye Injuries
• Lacerations• Suspected Perforation or Rupture of the Globe• Hyphema• Blunt Trauma• Chemical/Thermal/Radiation Burn• Corneal Abrasion• Foreign Body
![Page 8: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/8.jpg)
Illinois EMSC 8
Eyelid Laceration
![Page 9: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/9.jpg)
Illinois EMSC 9
Corneal Laceration
![Page 10: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/10.jpg)
Illinois EMSC 10
Corneoscleral Laceration
![Page 11: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/11.jpg)
Illinois EMSC 11
BLUNT TRAUMA• Symptoms
– Pain
– High risk for orbital fracture and intraorbital bleeding
– Decrease or loss in vision
• Cover eye loosely
• Transport to ED or MD
![Page 12: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/12.jpg)
Illinois EMSC 12
Perforation/Rupture of the Globe
• Call EMS• Avoid increasing intraocular pressure (have
student sit upright, restrict activity, avoid blowing nose)
• Patch affected eye• Cover both eyes• Do not leave alone• If impaled object
– Stabilize object-do not remove!
![Page 13: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/13.jpg)
Illinois EMSC 13
Subconjunctival Hemorrhage
![Page 14: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/14.jpg)
Illinois EMSC 14
Orbital Floor Fracture
![Page 15: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/15.jpg)
Illinois EMSC 15
HYPHEMA• Caused by trauma to the eye• Injury to iris blood vessel• Bleeding into anterior chamber• Decreased vision• Treatment
– Restrict activity– Cover eye with shield– Refer for ophthalmologic exam or transport to ED
![Page 16: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/16.jpg)
Illinois EMSC 16
HYPHEMA
![Page 17: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/17.jpg)
Illinois EMSC 17
Hyphema
![Page 18: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/18.jpg)
Illinois EMSC 18
Burns• Chemical Burns
– Call EMS– Irrigate continuously, gently
• Heat Burns– Apply a loose, moist dressing
• Light Burns– Symptoms delayed - bilateral– Cover both eyes with dark patches
![Page 19: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/19.jpg)
Illinois EMSC 19
Alkali Burn of the Cornea
![Page 20: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/20.jpg)
Illinois EMSC 20
Corneal Ulcer
![Page 21: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/21.jpg)
Illinois EMSC 21
Corneal Abrasions
• Common
• Caused by scratches, small foreign bodies, or contacts
• Present with pain and light sensitivity
• Refer to ophthalmologist/MD
![Page 22: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/22.jpg)
Illinois EMSC 22
Corneal Foreign Body
![Page 23: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/23.jpg)
Illinois EMSC 23
Eye Injury Prevention• Education
• Require use of protective eyewear
• Investigate causes of eye injuries and remove hazards
• Collaborate with school staff to reduce incidence of injury
![Page 24: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/24.jpg)
Illinois EMSC 24
ENT Emergencies
![Page 25: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/25.jpg)
Illinois EMSC 25
Special Considerations
• Common in school age population
• Can be life-threatening
• May cause great anxiety
• Usually non-urgent
![Page 26: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/26.jpg)
Illinois EMSC 26
Selected ENT EmergenciesEar• Laceration
• Hematoma
• Abrasions
• Foreign Body
• Burns
• Frostbite
Nose• Nasal fracture
• Epistaxis
• Foreign Body
• Acute Sinusitis
Throat• Tonsillitis
• Streptococus infection
• Peritonsillar abscess
• Epiglottis
• Retropharyngeal abscess
![Page 27: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/27.jpg)
Illinois EMSC 27
Interventions In Ear Emergencies
• Lacerations/avulsions– Pad between scalp and
ear
– Assess for tetanus status
• Hematomas– Refer for possible
aspiration
• Abrasions– Clean the area
– Assess for tetanus status
• Foreign bodies– Attempt to remove if near
external meatus– Avoid excessive
manipulation
• Burns– Wrap lightly in gauze– Pad between scalp and ear
• Frostbite– Rewarm in warm water– Avoid excessive heat
![Page 28: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/28.jpg)
Illinois EMSC 28
Interventions In Nose Emergencies
• Nasal fracture– Check for related injuries (e.g. head injury)– Ice– Refer to ED/MD
• Epistaxis– Firm pressure for 10-15 minutes– Refer if bleeding continues or frequent epistaxis
• Foreign body– Have student blow nose vigorously– Remove only if easily retrievable
• Acute Sinusitis– Refer to primary care provider
![Page 29: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/29.jpg)
Illinois EMSC 29
Interventions in Throat Emergencies
• Tonsillitis/Streptococcus infection– Refer to primary care provider
• Peritonsillar abcess/cellulitis– Severe pain, dysphagia– Urgent - refer to MD for treatment
• Epiglottitis - emergent!!– Monitor ABC’s and call EMS
• Retropharyngeal abscess - emergent!!– Monitor ABC’s and call EMS
![Page 30: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/30.jpg)
Illinois EMSC 30
Prevention
• Ear protection from loud noises
• Isolation of infected students
• Protective padding and helmets for sports
– Correct size and fit
– Educate students in proper use
![Page 31: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/31.jpg)
Illinois EMSC 31
Dental Emergencies
![Page 32: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/32.jpg)
Illinois EMSC 32
Assessment Of Dental/Oral Trauma
• Use body substance isolation precautions
• ABC’s
• Types include:
– Soft tissue
– Impaled objects
– Injury to tooth
– Injury to bony structures
![Page 33: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/33.jpg)
Illinois EMSC 33
Soft Tissue Trauma• Laceration/Bleeding
– Apply direct pressure and ice– If major bleed (over 5 minutes) - call EMS
• Edema– If swelling related to trauma - apply ice– Airway compromise, difficulty talking – call EMS
• Impaled Object– Emergent-call EMS– Apply cold packs– Pack gauze sponges around object to secure it
![Page 34: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/34.jpg)
Illinois EMSC 34
Dental Trauma• Fracture of a tooth
– Small, cover with dental wax
– Large, emergent-refer to dentist
• Displacement of tooth
– Refer to dentist
• Avulsion of tooth
– Replace if possible
– Store appropriately for transport with student to dentist
– Send to dentist within the hour
![Page 35: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/35.jpg)
Illinois EMSC 35
Bony Fractures• Alveolar Fracture
• LeForte Fracture
• Mandible fracture
• Fracture of the zygomatic arch
![Page 36: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/36.jpg)
Illinois EMSC 36
Bony Fracture Interventions
• Assess ABC's
• Check for abnormal movement
– Teeth
– Upper or lower jaw
• Ice and direct pressure for bleeding
• Emergent - call EMS!
• For mandible fracture, stabilize jaw by wrapping a cravat around the protuberance of chin and top of head
• Transport to ED
![Page 37: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/37.jpg)
Illinois EMSC 37
Dental Pain
• Caries
• Exfoliation
• Eruption
• Orthodontic appliances
![Page 38: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/38.jpg)
Illinois EMSC 38
Soft Tissue Pain• Types
– Bleeding gums– Fistula and edema– Ulcers
• Most are non-urgent• URGENT CONDITIONS
– Fistula or swelling• Non-draining• Risk of airway compromise from cellulitis
– Diffuse ulcers• Fever and malaise• Refer for diagnosis and cause
![Page 39: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/39.jpg)
Illinois EMSC 39
Psychosocial Pain• Dysmorphism
– Facial disfigurement– Craniofacial abnormalities
• Urgent• May be subjected to peer teasing or harassment• Refer to craniofacial team
• Oral Habits– Thumb/finger sucking
• Non-urgent• May result in malocclusion as well as social ridicule• Refer to dentist
![Page 40: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/40.jpg)
Illinois EMSC 40
PREVENTION
Protective devices are recommended for sport and recreational activities to decrease/prevent the risk of injuries
• Total head and larynx protection – football, hockey, lacrosse, baseball catchers, batters
• Full face protection – fencing, hockey goalies• Eye protectors – all racquet sports, soccer,
basketball, softball
![Page 41: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/41.jpg)
Illinois EMSC 41
SUMMARY
Pain or injury involving the eyes, ears, nose, throat or oral structures often evokes tremendous anxiety in students. Always maintain a reassuring demeanor as you perform your assessment and management.
Develop and conduct injury prevention programs and implement safety measures to prevent EENT emergencies.
![Page 42: Illinois EMSC1 EENT and Dental Objectives Upon completion of this lecture, you will be better able to: List the steps in assessing an eye injury Describe](https://reader035.vdocument.in/reader035/viewer/2022070407/56649e105503460f94afb0d0/html5/thumbnails/42.jpg)
Illinois EMSC 42
Any Questions??