Chapter 28 Face and Head Injuries EMT

Possible causes of unequal pupils include:

• Use of over-the-counter eye drops

• previous eye surgeries or injuries.

• Certain asthma inhalers (if inadvertently sprayed into the eye)

• Brain injury

• Nerve disease

• Glaucoma

• Meningitis

Test for the following:

• Does the patient have the ability to follow your finger from side to side as well as up and down?

• Can the patient read normal print?

• Does the patient report blurry vision in either eye?

• Is there a new sensitivity to light?

Once the patient is immobilized in a cervical collar and on a backboard,

turn the backboard to one side to allow any blood or vomitus to drain out of the mouth.

When an injury exposes the brain, eye, or other structures,

cover the exposed parts with a moist, sterile dressing to protect them from further damage.

If you spot a foreign object on the surface of the eyelid,

you may be able to remove it with a moist, sterile cotton-tipped applicator.

If a small foreign object is lying on the surface of the patient’s eye,

use a normal saline solution to gently irrigate the eye.

For thermal eye burns

First, however, cover both eyes with a sterile dressing moistened with sterile saline. You may apply eye shields over the dressing.

For light burns on eyes

You can ease the pain by covering each eye with a sterile, moist pad and an eye shield.

On rare occasions, the eyeball may be displaced out of its socket.

Do not attempt to reposition it.

Cover the eye and stabilize it with a moist, sterile dressing.

Cover both eyes to prevent further injury because of sympathetic movement.

Have the patient lie in a supine position en route to the hospital to prevent further loss of fluid from the eye.

hyphema

blood pooling at bottom of eye, covering iris

Retinal detachment signs

It is painless but produces flashing lights, specks, or floaters in the field of vision and a cloud or shade over the patient’s vision.

For unconscious patients with eye injuries following head injuries

cover the eye lids with moist gauze or hold them closed with clear tape.

The only time that contact lenses should be removed immediately in the field

is in the case of a chemical burn of the eye

If CSF is present

the blood will be surrounded by a lighter ring of fluid.

This is called the halo test.

Before bandaging ear injury

place dressing between ear and head

When dealing with an avulsed tooth,

handle it by its crown and not by the root.

Signs and symptoms of larynx injuries include:

Respiratory distress

Hoarseness

Pain

Difficulty swallowing (dysphagia)

Cyanosis

Pale skin

Sputum in the wound

Subcutaneous emphysema

Bruising on the neck, hematoma, or bleeding