Emergency Medicine Chapter 27
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Questions and Answers

What condition should you suspect in a 30-year-old female with redness, inflammation, and pain to her left eye?

conjunctivitis

What should you do if a 4-year-old female has a peanut lodged in the external auditory canal?

transport her to the emergency department

What steps should you take for a 52-year-old female who has facial swelling and several dislodged teeth following a collision?

fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, and transport

What intervention will most likely improve the chance of survival for a 6-year-old female with difficulty breathing and facial cyanosis after hitting her throat on a clothesline?

<p>rapidly transporting her to the hospital</p> Signup and view all the answers

What should you do if a factory worker was splashed in the eyes with a strong acid chemical and your ambulance does not have sterile saline?

<p>irrigate both eyes continuously for 20 minutes with plain water</p> Signup and view all the answers

How is bleeding from soft-tissue injuries to the face most effectively controlled?

<p>direct pressure using dry, sterile dressings</p> Signup and view all the answers

What clinical presentation is most consistent with a blowout fracture in a patient who has sustained facial trauma?

<p>severe headache and decreased ability to move his eyes</p> Signup and view all the answers

If your patient swallows blood following facial trauma, there is an increased risk of ________.

<p>vomiting</p> Signup and view all the answers

Significant trauma to the face should increase the EMT's index of suspicion for what type of injury?

<p>spinal column injury</p> Signup and view all the answers

What is the Adam's apple?

<p>the upper part of the larynx that is formed by the thyroid cartilage</p> Signup and view all the answers

What is the most significant complication associated with facial injuries?

<p>airway compromise</p> Signup and view all the answers

Where can the superficial temporal artery be palpated?

<p>just anterior to the tragus</p> Signup and view all the answers

What are the upper jawbones called?

<p>maxillae</p> Signup and view all the answers

When a light is shone into the pupil, what should happen?

<p>it should become smaller in size</p> Signup and view all the answers

What should the EMT's immediate priority be when caring for a patient with an open facial injury?

<p>wear gloves and facial protection</p> Signup and view all the answers

When performing a full body scan, you should assess for ________.

<p>DCAP-BTLS</p> Signup and view all the answers

Why is it important to be descriptive when transporting a patient with a facial injury to the hospital?

<p>they may need to call a specialist to see the patient</p> Signup and view all the answers

Which of the following statements regarding anterior nosebleeds is correct?

<p>They usually originate from the septum area and bleed slowly</p> Signup and view all the answers

Which of the following statements regarding the vitreous humor is correct?

<p>It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost</p> Signup and view all the answers

What is the most pertinent question to ask a 59-year-old male with unequal pupils during a medical history evaluation?

<p>has a history of eye surgeries</p> Signup and view all the answers

The maxilla and zygoma are components of the ________.

<p>face</p> Signup and view all the answers

What is the most common type of facial fracture?

<p>nasal</p> Signup and view all the answers

What is the function of the sternocleidomastoid muscle?

<p>allows movement of the head</p> Signup and view all the answers

What is the opening in the center of the iris called?

<p>pupil</p> Signup and view all the answers

How do soft tissues of the face typically behave when injured?

<p>have a rich blood supply and bleed profusely</p> Signup and view all the answers

Why is it important to identify and treat facial injuries as soon as possible?

<p>of the risk for airway problems</p> Signup and view all the answers

Why are frequent reassessments of patients with face or neck injuries important?

<p>such injuries can affect the respiratory system</p> Signup and view all the answers

What should you do if an immobilized patient with severe facial trauma begins vomiting blood?

<p>turn the backboard onto its side</p> Signup and view all the answers

What is the appropriate treatment for a 22-year-old male who has sand blown into his eyes?

<p>irrigating his right eye laterally</p> Signup and view all the answers

Which of the following findings would be least suggestive of a head injury?

<p>briskly constricting pupils when exposed to light</p> Signup and view all the answers

What should you do for a 50-year-old male splashed in the eyes with radiator fluid?

<p>carefully remove the contact lenses and then irrigate his eyes with saline</p> Signup and view all the answers

What is the most appropriate care for a 29-year-old male with an anterior nosebleed after being elbowed in the nose?

<p>leaning him forward and pinching his nostrils together</p> Signup and view all the answers

What should you ensure when treating a laceration to the ear of a 44-year-old male after a minor car accident?

<p>padding between the ear and the scalp</p> Signup and view all the answers

What injury should you suspect if a young male presents with labored breathing, loss of voice, and subcutaneous emphysema after neck trauma?

<p>laryngeal fracture</p> Signup and view all the answers

What should you do if you assess bright red blood spurting from a laceration on the neck?

<p>apply direct pressure above and below the wound</p> Signup and view all the answers

What is the small, rounded, fleshy bulge immediately anterior to the ear canal called?

<p>tragus</p> Signup and view all the answers

How are the conjunctiva kept moist?

<p>by fluid produced by the lacrimal glands</p> Signup and view all the answers

What would most likely indicate a brain injury as observed in a patient?

<p>abnormal variations in pupil size and reaction</p> Signup and view all the answers

What should you do for a young female with pain to her left eye and a piece of glass impaled in it?

<p>apply direct pressure to her arm wound</p> Signup and view all the answers

What is 'hyphema' defined as?

<p>blood in the anterior chamber of the eye</p> Signup and view all the answers

What is a hematoma?

<p>a collection of blood within the tissues</p> Signup and view all the answers

Which type of fracture is associated with bruising around the ears and blood coming from the nose?

<p>basilar skull fracture</p> Signup and view all the answers

What is an air embolism?

<p>a clinical situation in which a vein is punctured and air is sucked into the heart</p> Signup and view all the answers

What should be assessed if you feel subcutaneous emphysema?

<p>neck</p> Signup and view all the answers

What is the clinical significance of the tragus?

<p>the small, rounded, fleshy bulge that lies immediately anterior to the ear canal</p> Signup and view all the answers

What do lacrimal glands produce?

<p>fluids to keep the eye moist; also called tear glands</p> Signup and view all the answers

What is the sclera?

<p>the tough, fibrous, white portion of the eye that protects the more delicate inner structures</p> Signup and view all the answers

What is the function of the retina?

<p>The light-sensitive area of the eye where images are projected</p> Signup and view all the answers

What is the term for naturally occurring uneven pupil size?

<p>anisocoria</p> Signup and view all the answers

What is the purpose of the lens in the eye?

<p>the transparent part of the eye through which images are focused on the retina</p> Signup and view all the answers

What does retinal detachment mean?

<p>separation of the retina from its attachments at the back of the eye</p> Signup and view all the answers

What is the optic nerve's function?

<p>A cranial nerve that transmits visual information to the brain</p> Signup and view all the answers

What are turbinates in relation to the nasal cavity?

<p>layers of bone within the nasal cavity</p> Signup and view all the answers

What is the tympanic membrane commonly known as?

<p>ear drum</p> Signup and view all the answers

What is the eustachian tube's role?

<p>connects the middle ear to the oropharynx</p> Signup and view all the answers

What is subcutaneous emphysema?

<p>a characteristic crackling sensation felt on palpation of the skin, caused by the presence of air in soft tissues</p> Signup and view all the answers

What is posterior epistaxis and why is it serious?

<p>is more serious than anterior epistaxis and often causes blood to drain into the patient's throat, causing nausea and vomiting</p> Signup and view all the answers

Study Notes

Eye Injuries and Conditions

  • Conjunctivitis: Inflammation of the conjunctiva, characterized by redness, inflammation, and pain.
  • Hyphema: Presence of blood in the anterior chamber of the eye, indicating possible serious injury.
  • Corneal Injury: Glass impaled in the eye can impair vision; management includes direct pressure to other wounds while stabilizing the head.
  • Vitreous Humor: Clear, jellylike fluid in the back of the eye; cannot be replaced if lost.
  • Pupil Response: Should constrict when light is shone; uneven pupils may suggest brain injury.

Facial Injuries

  • Common Facial Fractures: Nasal fractures are the most prevalent type of facial injuries.
  • Blowout Fracture: Characterized by double vision and difficulty in eye movement; often occurs with blunt trauma to the face.
  • Soft Tissue Injuries: Bleeding is most effectively controlled with direct pressure using dry, sterile dressings.
  • Airway Compromise: Most significant complication related to facial injuries; immediate assessment and management are crucial.
  • Laryngeal Fracture: Presents with labored breathing, loss of voice, and subcutaneous emphysema after trauma to the neck.

Emergency Response

  • Transport Decisions: Rapid transport is critical for patients with compromised breathing or significant trauma (like struck by a clothesline).
  • Open Facial Injuries: Priority for EMTs is to wear gloves and facial protection to prevent contamination.
  • Nosebleeds Management: Anterior nosebleeds typically originate from the septum and are best managed by having the patient lean forward and pinch nostrils.
  • Lacerations: For neck lacerations, apply direct pressure above and below the injury site to control bleeding.

Anatomy and Physiological Functions

  • Maxillae and Zygoma: These bones form major components of the facial structure.
  • Thyroid Cartilage: The Adam's apple, part of the upper larynx, is formed from this cartilage.
  • Sternocleidomastoid Muscles: Located on each side of the neck, responsible for head movement.
  • External Auditory Canal: Ear canal leading to the tympanic membrane.

Signs of Injury

  • Subcutaneous Emphysema: Crackling sensation felt under the skin, indicating air trapped in soft tissues.
  • Anisocoria: Naturally occurring uneven pupil size; relevant in assessing head injuries.
  • Cyanosis: Indicates inadequate oxygenation; observed in facial injuries.

Treatment Protocols

  • Eye Irrigation: If chemicals are splashed in the eyes, irrigate with plain water for at least 20 minutes.
  • Direct Pressure for Neck Injuries: Apply direct pressure to control bleeding, and use a sterile occlusive dressing if necessary.
  • Oropharyngeal Airway: Insert to manage airway in unconscious patients with altered level of consciousness or labored breathing.

Patient Transportation

  • Communication with Hospitals: Important for describing injuries so specialists can be on alert for necessary interventions.
  • Reassessment of Patients: Frequent checks are vital as facial and neck injuries can rapidly affect respiratory function.

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Test your knowledge on face and neck injuries with this flashcard quiz. Each card presents a scenario related to emergency responses, enhancing your understanding of critical medical conditions. Perfect for students and professionals in the medical field.

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