Head, Nose, Mouth and Ear Injuries

1
Head, Nose, Mouth and Ear Injuries

• PED 477
• Care and Prevention of
• Athletic Injuries

2
Momentum

• Skull movement
• Brain movement
• Stoppage
• Traumatic Comp.
• A-traumatic comp.
• Jarring
• repetition

3
Protective Equipment

• Any loose layer reduces force
• Shell with foam absorbs/disperses force
• Rounded
• Deflects force

4
Brain Injuries

• Concussion
• Impaired function (varying time frame)
• No structural damage to speak of directly
• Can lead to degradation over time
• Extreme variance in severity
• LOC
• Diffuse

5
Brain Injuries

• Hematoma (focal)
• Epidural
• arterial bleeding
• quick onset
• less common
• Subdural
• venous bleeding
• wide range of onset time
• can build on each other without symptoms

6
Significant Head Injuries

• Signs of increased intercranial pressure
• Aniscoria
• Visual difficulties
• Vomiting
• Dyspnea
• Decreased pulse

7
Concussion Grading

• Grade I
• Usually no LOC
• Never more than 30 seconds
• Symptom resolution
• 15 minutes 24 hours
• Post-traumatic amnesia
• lt24 hours

Mild
8
Concussion Grading

• Grade II
• LOC
• Never more than 5 minutes
• Symptom resolution
• 30 minutes 72 hours
• Post-traumatic amnesia
• None 48 hours
• Retrograde amnesia
• lt48 hours

Moderate
9
Concussion Grading

• Grade III
• LOC
• 1 5 minutes or more
• Symptom resolution
• gt3 hours
• Post-traumatic amnesia
• gt24 hours
• Retrograde amnesia
• gt24 hours

Severe
10
Middle Ear Pathology

• Otitis Media
• Suppurative
• Serous
• TM Perforations
• Tympanosclerosis
• Cholesteatoma

11
Suppurative Otitis Media
12
Ruptured Tympanic Membrane

• Sx Sudden pain, discharge, ringing, partial
  hearing loss, some relief
• Causes Object insertion, sudden inward
  pressure, sudden outward pressure, severe middle
  ear infection
• Tx Rx meds, pain relief, keep canal dry, surgery
  if improper healing

13
Hematoma of the AuricleCauliflower Ear

• Blunt trauma
• Blood between the perichondrium and cartilage
• Very common wrestling injury
• Prompt tx to remove the fluid is indicated,
  followed by direct pressure
• Surgical interventions

14
Septal Deviation

• Ask athlete to breathe in nostril
• Examine with pen light or rhinoscope
• Dont blow nose
• Closed repair
• 5-7 days

15
Nasal Injuries

• Epistaxis (nosebleed)
• Causes
• picking
• hypertension
• infection
• dryness
• contusion
• fracture

16
Avulsed Tooth
17
Dental Injury

• Loose tooth
• displaced
• replace and refer
• intruded
• no treatment, but refer
• extruded
• attempt replacement and refer
• avulsed (dislocated)
• rinse tooth and mouth (saline dont touch root)
• replace (or store) and refer

18
Lip Lacerations

• Inside versus outside
• Holes through
• Antibiotic?
• Sutures? How long?