Chapter 33 Eye, Face, and Neck Trauma Copyright ©2010 by Pearson Education, Inc. All rights reserved. Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren

Back to Topics Anatomy of the Eye, Face, And Neck

Arteries Veins Airway Trachea Larynx Spine

Eye, Face, and Neck Injuries Back to Topics

Scene Size-Up Dispatch information Mechanism of injury Scene safety

Primary Assessment Use manual in- line stabilization Control bleeding Assess ABCs Consider ALS Administer O 2

Secondary Assessment Palpate –Eye socket –Bones of cheek –Nose –Jaw Vital signs Treat for shock History Signs and symptoms Reassessment

Specific Injuries Involving the Eye, Face, and Neck Back to Topics

Assessment and Care Guidelines Areas to evaluate Eye movements Basic rules for emergency medical care

Foreign Objects in the Eye Presentation Treatment

Injury to the Orbits Cause Signs and symptoms Emergency medical care

Lid Injury Types Signs and symptoms Emergency medical care

Injury to the Globe Types Emergency medical care (Charles Stewart, M.D. & Associates)

Chemical Burn to the Eye Immediate treatment Signs and symptoms Emergency medical care Contact lenses (© Chris Barry/PhototakeUSA)

Impaled Object in the Eye or Extruded Eyeball Do not remove Emergency medical care Transport

Removing Contact Lenses Guidelines for removal Removing soft contact lenses Removing hard contact lenses

Assessment and Care Guidelines Establish manual in- line stabilization Assess ABCs Emergency medical care

Avulsed Tooth If a tooth has been lost, try to locate it; reimplantation is often possible Treatment for patient and tooth –Rinse with saline and gently remove debris –Transport in a cup of saline or wrapped in gauze soaked in sterile saline –Guard against the tooth drying out –Never handle tooth by the root end –Control bleeding from the tooth socket

Injury to the Mid-Face, Upper Jaw, or Lower Jaw Types Signs and symptoms Emergency medical care

Object Impaled in the Cheek If object is obstructing airway and must be removed Remove opposite way the object entered Pack dressing between teeth and wound Dress and bandage outside of wound Consider ALS for airway control Suction frequently

Injury to the Nose ABCs Types of trauma Emergency medical care

Injury to the Ear Types Emergency medical care

Types Signs and symptoms Emergency medical care

If spinal injury is not suspected, position the patient on his left side, head tilted downward. (If spinal injury is suspected and the patient is immobilized to a spine board, board and patient can be turned and tilted as a unit.) Continue administration of oxygen. Care for shock, and transport.