Dr Pierre Viviers. Complain of pain above shoulder > injury Associated injuries Airway/ C-spine ...
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Transcript of Dr Pierre Viviers. Complain of pain above shoulder > injury Associated injuries Airway/ C-spine ...
Dr Pierre Viviers
Complain of pain above shoulder > injury
Associated injuries Airway/ C-spine Needs medical
attention Anatomy
Blow-out #: Blunt trauma (elbow) Compression (globe & orbital
contents) Fracture – orbital floor Peri-orbital bleeding Sunken eye Double vision on upward gaze
(entrapment of inferior rectus muscle)
Numbness of cheek Refer doctor Immediate anti-
biotic Specialized management
All eye injuries-thorough medical examination
Serious injuries-immediate referral (ophthalmologist)
Difficult dilemma-distinguish
Immediate referral: Severe eye pain Persistent photophobia Penetrating injury: pear
shaped pupil Hyphema Embedded FB Markedly impaired
visual acuity Loss visual field
Corneal Abrasion: Common, red & painful Rinse & refer AntibioticSub-conjunctiva Bleeding: No treatmentHyphema: Bleeding (cornea/ iris) Severe pain/ blurred
vision Refer (rest & pressure)Retinal Detachment: Light flashes “Curtain” – field of vision Urgent referralEyelid Lacerations: Exclude coexisting injuries Lachrymal duct (medial)
Epistaxis: Little`s Area Digital compression (sitting
upright) Cold compression on the
bridge > 20min - Refer
Nasal Fractures Septal Hematoma
Auricular Hematoma : Cauliflower Ear External contusion Bleeding between layers Swelling, pain & tender Refer: medical
managementTympanic Membrane Rupt:
Blow to side of head Pain, bleeding & hearing
impairment Refer: medical
examination
Fractures: Common – blow to jaw Associated injuries More than one site (both sides
of the midline) Swelling, tender & painful Misalignment of teeth &
bleeding Airway (conscious/
unconscious): Positioning (ABC) Forward sitting &supporting
jaw with both hands Cervical collar, immediate
referral
Dislocation (TMJ): Blows to mandible Common Pain Malocclusion Inability to close Management:
Reduce (down & back
Refer
Fractures, luxated, avulsed: Common-blows against the
head Thorough examination of
oral cavity Missing tooth – swallow >
complication Management:
Protect fragment (milk, saline, under tongue
Handled by crown Reposition/ place back Replace within 60 min Unconscious (replaced <
2hrs)
Laceration: Accidental bite Bleeding General Principles:
Rinse/ pressure
Extensive Injuries needs careful suturing
Thank You
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