External Ear Injury
Cauliflower Ear
Ear avulsion
Rupture tympanic membrane - overpressure from explosion or direct blow to the ear
Ruptured Tympanic Membrane
Failure to equalize middle ear pressure from scuba diving too
Principal signs and symptoms are pain nad vertigo + vomiting
Eye injuries:
Eyelid lacerations
Conjunctival and corneal injuries
Hyphenated - blood in the front of eye
Ocular globe rupture - leak vitreous humor form penetrating or blunt trauma
Ocular avulsion - eye outside of socket
Retina detachment - new onset of blindness, spiderweb vision, black spots
Madibular fx and dislocation
Single blow to this bone can cause multiple fractures around its length
S/s crepitus/trismus/swelling/ jaw doesn’t feel right or can’t close.
Dental avulsion management
Never place an avulsed tooth in anything that can dry or crush the outside of the tooth. Do not handle the tooth roughly. Do not rinse it off or rub, scrape, or disinfect the outside of the tooth.
Place the tooth in a soft transport device, preferably in Hank’s solution (a pH-balanced, isotonic, glucose/calcium/magnesium solution). Do not use tap water. Some recommendations suggest whole milk as a second-best solution to Hank’s solution. A third choice is saline, but only for less than 1 hour.
Retinal detachment management
A rigid metal eye shield, rather than a soft patch, should be used to protect the eye.
Ocular avulsion management
Proper care includes protecting the eye from further trauma in transit by using a protective cup or other rigid protective device with moistened gauze padding.
Ocular globe rupture management
Protect the affected eye with a rigid eye shield or cup.
Administer antiemetics and pain medication.
If necessary, administer an antitussive to prevent increased intraocular pressure as the result of coughing.
Hyphema management
Patch both eyes (controversial).
Transport the patient sitting as upright as possible. Administer analgesics; avoid antiplatelet agents. Administer an anxiolytic if necessary to facilitate transport.
Grades of hyphema
Grade 1: Layered blood occupying less than one-third of the anterior chamber
Grade 2: Blood filling one-third to one-half of the anterior chamber
Grade 3: Layered blood filling one-half to less than the total anterior chamber Grade 4: Total clotted blood, often called a blackball or 8-ball hyphema
Grade 1
Layered blood occupying less than one-third of the anterior chamber
Blood filling one-third to one-half of the anterior chamber
Grade 2
Layered blood filling one-half to less than the total anterior chamber
Grade 3
Total clotted blood, often called a blackball or 8-ball hyphema
Grade 4
Conjunctival and corneal injuries
From abrasions and foreign bodies.
Cover eye with bulky dressing on both eyes.
Eye lid lacerations
Direct pressure and don’t push on globes. Cold applications help reduce swelling.
General Eye trauma/burn management
Adequate washing is essential and should be performed with (preferably) sterile saline or dextrose solution for at least 10 minutes prior to transport for acid burns and at least twice as long for alkali burns
