Sensory Emergencies

1
Sensory Emergencies

• Eyes, Ears, Nose

2
Anatomy

• Review in book!
• Ch 25 26

3
Eye Parts

• Conjunctiva
• Lacrimal Glands
• Sclera
• Pupil
• Iris
• Cornea
• Lens
• Retina
• Optic nerve

• Vitreous humor
• Aqueous humor

4
Eye Injuries

• enucleation
• laceration
• foreign objects
• abrasion
• burns

5
Eye injuries - notes

• Signs can be subtle
• Example - hyphema
• (blood in anterior chamber of eye)

6
Lacerations

• Cut to the globe or surrounding tissue
• Never exert pressure on or manipulate the eye
• If part of eyeball is exposed, apply a moist,
  sterile dressing and eye shield

7
Foreign Objects in the Eye

• small foreign objects - irrigate with saline
• Flush from the nose outward
• Never attempt to remove an object on the cornea

8
Impaled Object

• Do not remove it
• Immobilize the object in place
• Moist sterile dressing over the injured eye only
• LA county

9
Chemical Burns

• Irrigate - Irrigate - Irrigate
• Use water or saline solution
• 20 minutes
• powder or liquid irrigate
• Dry dressing

10
Thermal Burns

• Usually to the eyelid
• Cover both eyes with a moist, sterile dressing
  and eye shield
• Transport supine to burn center.

11
Light Burns

• Infrared rays, eclipse light, direct sunlight,
  laser burns
• Welding without protection
• Burns on cornea
• Very painful
• Cover eyes with sterile pad and eye shield.
• Transport supine

12
other...

• Not Trauma Related
• blurred vision
• double vision
• sudden blindness
• Think CVA or other neurological

13
Eye Injuries Following a Head Injury

• One pupil larger than the other
• Eyes not moving together
• Failure of the eyes to follow equally
• Bleeding under the conjunctiva
• Protrusion or bulging of one eye

14
Contact lenses

• Leave in place unless chemical burn
• Trying to remove them can damage cornea
• If irrigation removes them - fine
• If patient removes them - fine
• If there is no function in an eye, ask if the
  patient has an artificial eye

15
Ear Anatomy

• External ear
• Middle ear
• Inner ear

16
Injuries of the Ear

• Doesnt usually bleed much.
• Place a dressing between ear and scalp
• For avulsion, moist sterile dressing.
• Do not try to remove a foreign body
• CSF/blood
• Ruptured tympanic membrane

17
Ears - notes

• ringing in ears
• sudden deafness - CVA?
• Inner ear infections - Vertigo

18
Nasal Anatomy

• Septum
• Turbinates
• Frontal sinus

19
Injuries of the Nose

• Blunt trauma can cause fractures and soft-tissue
  injuries.
• CSF/blood
• Use dry sterile dressing for soft tissue injuries
• Object inserted in nose can be removed if freely
  movable
• Impaled objects get bulky dressing

20
Nose Bleeds

• Lean forward
• Pinch nostrils and hold
• Blood is an irritant to the stomach
• Hypertensive?

21
the end

• Next!