Emergency Medicine Chapter 27

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?

rapidly transporting her to the hospital 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?

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

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

direct pressure using dry, sterile dressings Signup and view all the answers

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

severe headache and decreased ability to move his eyes Signup and view all the answers

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

vomiting Signup and view all the answers

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

spinal column injury Signup and view all the answers

What is the Adam's apple?

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

What is the most significant complication associated with facial injuries?

airway compromise Signup and view all the answers

Where can the superficial temporal artery be palpated?

just anterior to the tragus Signup and view all the answers

What are the upper jawbones called?

maxillae Signup and view all the answers

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

it should become smaller in size Signup and view all the answers

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

wear gloves and facial protection Signup and view all the answers

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

DCAP-BTLS Signup and view all the answers

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

they may need to call a specialist to see the patient Signup and view all the answers

Which of the following statements regarding anterior nosebleeds is correct?

They usually originate from the septum area and bleed slowly Signup and view all the answers

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

It is a clear, jellylike fluid near the back of the eye that cannot be replaced if it is lost 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?

has a history of eye surgeries Signup and view all the answers

The maxilla and zygoma are components of the ________.

face Signup and view all the answers

What is the most common type of facial fracture?

nasal Signup and view all the answers

What is the function of the sternocleidomastoid muscle?

allows movement of the head Signup and view all the answers

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

pupil Signup and view all the answers

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

have a rich blood supply and bleed profusely Signup and view all the answers

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

of the risk for airway problems Signup and view all the answers

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

such injuries can affect the respiratory system Signup and view all the answers

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

turn the backboard onto its side Signup and view all the answers

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

irrigating his right eye laterally Signup and view all the answers

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

briskly constricting pupils when exposed to light Signup and view all the answers

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

carefully remove the contact lenses and then irrigate his eyes with saline 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?

leaning him forward and pinching his nostrils together 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?

padding between the ear and the scalp 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?

laryngeal fracture Signup and view all the answers

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

apply direct pressure above and below the wound Signup and view all the answers

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

tragus Signup and view all the answers

How are the conjunctiva kept moist?

by fluid produced by the lacrimal glands Signup and view all the answers

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

abnormal variations in pupil size and reaction 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?

apply direct pressure to her arm wound Signup and view all the answers

What is 'hyphema' defined as?

blood in the anterior chamber of the eye Signup and view all the answers

What is a hematoma?

a collection of blood within the tissues Signup and view all the answers

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

basilar skull fracture Signup and view all the answers

What is an air embolism?

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

What should be assessed if you feel subcutaneous emphysema?

neck Signup and view all the answers

What is the clinical significance of the tragus?

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

What do lacrimal glands produce?

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

What is the sclera?

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

What is the function of the retina?

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

What is the term for naturally occurring uneven pupil size?

anisocoria Signup and view all the answers

What is the purpose of the lens in the eye?

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

What does retinal detachment mean?

separation of the retina from its attachments at the back of the eye Signup and view all the answers

What is the optic nerve's function?

A cranial nerve that transmits visual information to the brain Signup and view all the answers

What are turbinates in relation to the nasal cavity?

layers of bone within the nasal cavity Signup and view all the answers

What is the tympanic membrane commonly known as?

ear drum Signup and view all the answers

What is the eustachian tube's role?

connects the middle ear to the oropharynx Signup and view all the answers

What is subcutaneous emphysema?

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

What is posterior epistaxis and why is it serious?

is more serious than anterior epistaxis and often causes blood to drain into the patient's throat, causing nausea and vomiting 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.

Studying That Suits You

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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.