Emergency 911 Shane R. Kannarr, OD Grene Vision Group.
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Transcript of Emergency 911 Shane R. Kannarr, OD Grene Vision Group.
Emergency 911Emergency 911
Shane R. Kannarr, OD
Grene Vision Group
Define
EmergencyEmergentUrgentRoutine
Our PatientsOur Patients
Key QuestionsKey Questions
When did it start?Which eye is impacted?Has it happened before?What problems are you noticing?Do you have loss of vision?Do you have flashes or floaters?
Key Questions cont:Key Questions cont:
Are you having discharge? What type?Is your eye red?Has there been trauma to your eye?
Key responses to watch forKey responses to watch for
Loss of VisionFlashes or FloatersSevere PainSevere RednessLight SensitivityForeign Body
Follow up QuestionsFollow up Questions
Loss of Vision– All or part of the vision?– Is it transient?– Did it happen immediately or was it proceeded
by flashes and floaters
What could it be?What could it be?
Loss of Vision
Papilledema, TIA, migraine,CRAO, glaucoma, blood pressure change
Emergency, Emergent, Routine
Follow Up QuestionsFollow Up Questions
Flashes and Floaters– One eye or both?– Do they move around?– What were you doing when it started?– History?
How you ask mattersHow you ask matters
What could it be?What could it be?
Flashes and Floaters:
RD or break, PVD, migraine, posterior uveitis, vitreous hemorrhage
Emergency, Emergent, or Routine
Follow up QuestionsFollow up Questions
Pain
History of trauma? Contact lens wear?Is it mild or severe?Is it in the eyes or around the eyes?Does anything relieve the pain?Duration?
What could it be?What could it be?
In the eye (Ocular)– Dry eye, bleph, FD, episcleritis, or SPK– Abrasion, erosion, Anterior Uveitis
– Around the eye Sinusitis, orbital pseudotumor
Emergency, Emergent, Routine
Follow Up questiosFollow Up questios
Redness:– Is there discharge? What type?– Is there pain? How severe…?– When did it start? Is it getting progressively
worse?– Have you been treating the redness– Contact lens history?
What could it be?What could it be?
Redness:– CLARE
Conjunctivitis– Dry Eye– Sub conjunctival hemorrhage
– Emergency, Emergent, Routine
Follow Up Questions:Follow Up Questions:
Photophobia (Light Sensitivity)– Is it mild moderate or severe?– Contact lens history?– History of trauma?– Duration?
What could it be?What could it be?
Corneal issue, uveitis, conjunctivitis, migraine
Less common Meningitis
Emergency, Emergent, Routine
Follow Up QuestionsFollow Up Questions
Do you have any idea what it could be?What is your pain level?Has it impacted your vision?When did it happen?What steps did you take to help yourself?
What could it be?What could it be?
A foreign body
Emergency, Emergent or Routine
Talking to PatientsTalking to Patients
Instill confidenceKnow what you are talking aboutAsk pertinent questionsInstill ConfidenceProvide the patients ways to contact the
office after hours
Key pointsKey points
Have a plan in placeKnow the office protocolIt is not wrong to say “let me check with the
doctor and I will get back to you”Put yourself in the patients shoes
If it is not an emergencyIf it is not an emergency
Remember while it is not an emergency to the office, the patient is still very concerned
If at all possible the patient should be in the office if 24-48 hours
Ask the doctor if any thing can be done to make the patient more comfortable until they can be seen