Non Traumatic EENT Emergencies

1
Non Traumatic EENT Emergencies

• Eyes--Ears--Nose--Throat

2
Eye Emergencies

• Acute Glaucoma
• Central Retinal Artery Occlusion
• Retinal Detachment

3
Acute Glaucoma

• Increased intraocular pressure
• Caused by acute obstruction of aqueous humor
  outflow
• Signs/Symptoms
• Decreased visual acuity
• Colored halos around lights
• Severe eye pain radiating to head/face
• Nausea, vomiting
• Fixed, midposition pupil
• Steamy cornea

4
Acute Glaucoma

• Management
• Cover eyes
• Transport

5
Central Retinal Artery Occlusion

• Blockage of blood flow to retina
• Signs/Symptoms
• Sudden, painless, unilateral blindness
• Management
• Intermittent digital massage over closed eyelid
• Caution - monitor EKG
• Consider having patient rebreathe in paper bag

6
Retinal Detachment

• Separation of retina from underlying structures
• Signs/Symptoms
• Dark or irregular floaters
• Flashes of light
• Curtain or Veil in visual field
• Management
• Transport gently

7
Ear Emergencies/Urgencies

• Otitis Externa
• Otitis Media
• Foreign Bodies

8
Otitis Externa

• Localized or diffuse infection of ear canal
• Predisposing factors
• Wetness
• Irritants (hair dye/sprays)
• Trauma from cleaning ears

9
Otitis Externa

• Signs/Symptoms
• Itching, severe pain
• Loss of hearing if ear canal swells
• Foul smelling discharge
• Tenderness with traction on ear

10
Otitis Media

• Bacterial or viral infection of middle ear
• Usually secondary to upper respiratory infection
• Common in children 3 months to 3 years old

11
Otitis Media

• Signs/Symptoms
• Persistent, severe earache
• Fever, nausea, vomiting, diarrhea
• Red, bulging tympanic membrane

12
Foreign Bodies

• Common in young children
• Attempts to remove may damage tympanic membrane
• Transport to ER for removal
• Non-hydroscopic objects may be irrigated out
• Insects can be killed by placing mineral oil in
  ear canal

13
Nose/Throat Emergencies

• Nasal foreign bodies
• Epistaxis
• Peritonsillar Abscess (Quinsy)

14
Nasal Foreign Bodies

• Common in young children
• Foul-smelling, bloody, unilateral discharge
• Retained foreign bodies
• Rhinoliths
• Transport for removal

15
Epistaxis

• Causes
• Local infection
• Drying of mucous membranes
• Hypertension
• Trauma
• Bleeding tendencies
• Digital insertion

16
Epistaxis

• Management
• Anterior Bleed
• Pinch nostrils
• Pressure over upper lip at base of septum
• Local cold application
• Posterior Bleed
• May require packs or cauterization
• Patients may need volume replacement

17
Peritonsillar Abscess (Quinsy)

• Acute infection of soft tissue spaces around
  tonsil
• Signs/Symptoms
• Severe pain on swallowing
• Fever
• Tonsil displaced medially
• Respiratory distress