EMT Ch. 28- Face & Neck Injuries

major bones of the face

• nasal bone

• two maxillae (upper jaw)

• two zygomas (cheek)

• mandible (lower jaw)

tragus

small/rounded fleshy bulge immediately anterior to ear canal

mastoid process

prominent bony mass at base of skull

temporomandibular joint

allows for motion of mandible; located in front of ear

aniscoria

unequal pupils

in pts who are unconscious/have AMS, abnormal pupil reactions sometimes are a sign of ___

brain injury

guidelines for treating penetrating injuries of the eye

• never exert pressure on/manipulate injured eye in any way

• if part of eyeball is exposed, gently apply a moist/sterile dressing to prevent drying

• cover injured eye w/ protective metal eye shield, cup, sterile dressing; apply soft dressings to both eyes, provide prompt transport

hyphema

bleeding into anterior chamber of eye, obscuring part/all of iris

blow-out fracture

fracture of orbital bones caused by blunt trauma; can cause displacement of eye & cause double vision, pain, decreased vision

possible indicators of head injuries in eyes

• one pupil larger than the other in unconscious pt

• eyes not moving together or pointing in different directions

• failure of eyes to follow movement of finger as instructed

• bleeding under conjunctiva, obscuring sclera of eye

• protrusion/bulging of one eye

true/false: removing contact lenses should be limited to pts w/ chemical burn injuries to eye

true

anterior nosebleeds

• start from area of septum

• bleed slowly

• self-limited & resolve quickly

posterior nosebleeds

• usually caused by trauma to face/skull

• severe, often cause pt to swallow blood (leading to nausea/vomiting)

The superficial temporal artery can be palpated:

just anterior to the tragus

The mastoid process is located approximately:

1 inch posterior to the external opening of the ear

The Adam's apple is:

the upper part of the larynx that is formed by the thyroid cartilage

The cricoid cartilage:

is the only complete circular cartilage of the trachea

When caring for a patient with an open facial injury, the EMT's immediate priority should be to:

wear gloves & facial protection

Significant trauma to the face should increase the EMT's index of suspicion for a(n):

spinal column injury

A young female was involved in a motor vehicle crash. She complains of pain to her left eye, which appears to have a piece of glass impaled in it. Further assessment reveals a large laceration to her left forearm with active venous bleeding. As your partner manually stabilizes the patient's head, you should:

apply direct pressure to her arm wound

When transporting a patient with a facial injury, it is most important to be as descriptive as possible with the hospital regarding the patient's injuries because:

they might need to call a specialist to see the patient

You are transporting an immobilized patient with severe facial trauma. As you are preparing to give your radio report to the hospital, the patient begins vomiting large amounts of blood. You should:

turn the backboard onto its side

Bleeding from soft-tissue injuries to the face is most effectively controlled with:

direct pressure using dry, sterile dressings

A 30-year-old female presents with redness, inflammation, & pain to her left eye. During your assessment, you note that she is having difficulty keeping her eyes open. You should suspect that she is experiencing:

conjunctivitis

A 40-year-old male was in his woodworking shop when he felt a sudden, sharp pain in his left eye. Your assessment reveals a small splinter of wood embedded in his cornea. You should:

cover both of his eyes & transport to the hospital

A factory worker was splashed in the eyes with a strong acid chemical. He complains of intense pain & blurred vision. Your ambulance does not carry bottles of sterile saline or water. You should:

irrigate both eyes continuously for 20 minutes with plain water

Following blunt trauma to the face, a 21-year-old male complains of a severe headache & decreased ability to move his eyes. This patient's clinical presentation is most consistent with:

a blow-out fracture

A patient who is complaining of seeing flashing lights, specks, or "floaters" in his or her field of vision has most likely experienced:

a detached retina

A 39-year-old female experienced a severe closed head injury. She is unresponsive with her eyes slightly open; her pupils are bilaterally dilated & slow to react. In addition to managing problems with airway, breathing, & circulation, you should:

close her eyes & cover them with a moist dressing

A 50-year-old male was splashed in the eyes with radiator fluid when he was working on his car. During your assessment, he tells you that he wears soft contact lenses. You should:

carefully remove the contact lenses & then irrigate his eyes with saline

A 44-year-old male sustained a laceration to his left ear during a minor car accident. Your assessment reveals minimal bleeding. Appropriate care for this injury includes:

padding between the ear & the scalp

A 4-year-old female has a peanut lodged in the external auditory canal of her right ear. You should:

transport her to the emergency department

A 52-year-old unrestrained female struck the steering wheel with her face when her truck collided with another vehicle. She has obvious swelling to her face & several dislodged teeth. A visual exam of her mouth reveals minimal bleeding. She is conscious & alert with a blood pressure of 130/80 mm Hg, a pulse of 110 beats/min, & respirations of 22 breaths/min with adequate tidal volume. You should:

fully immobilize her spine, attempt to locate the dislodged teeth, suction as needed, & transport

Following direct trauma to the upper part of the anterior neck, a young male presents with labored breathing, loss of voice, & subcutaneous emphysema in the soft tissues around his neck. You should suspect a(n):

laryngeal fracture

You are dispatched to a convenience store, where the clerk sustained a laceration to the side of his neck during a robbery attempt. During your assessment, you note bright red blood spurting from the laceration. You should:

apply direct pressure above & below the wound