ent emergency 56

7/25/2019 Ent Emergency 56

1/19

1

11

Assoc. Prof. Darunee Junhavat 6 June 2013

radj1 @ yahoo.com

22

Ear emergency

1. Laceration of the auricle

2. Hematoma of the auricle

3. Perichondritis and Chondritis

4. Foreign body in ear canal

33

Ear emergencyEar emergency

5.5. Malignant otitis externa

6. Traumatic rupture of ear drum

7. Barotrauma

8. Sudden hearing loss

44

:

Laceration of the auricle

55

Laceration of the auricleLaceration of the auricle

- Aseptic technique dressing

- - Antibiotic and Analgesic*

- +/- Refer

66

Hematoma of the auricleHematoma of the auricle

:


2/19

2

77

Enzyme : Danzen, Denzo, Papase(Serratiopeptidase, Proteolytic enzyme)

Aspirate Antibiotic

88

Pressure dressing Aspirate

99

Perichondritis and ChondritisPerichondritis and Chondritis

: Hematoma, Laceration

1010

Perichondritis

:

Chondritis

1111

Chondritis

1212

Antibiotic Dressing


3/19

3

1313

Cauliflower ear

Post- perichondritis 1414

12

Post -Perichondritis Post-chondritis

1515

Foreign bodies in ear canalForeign bodies in ear canal

1616

1717 1818

Alligator/ Ear forceps

Ear wax curette


4/19

4

1919

Foreign bodies in ear canalForeign bodies in ear canal

-

: :

2020

2121

2222

Tragus

2323

2424

100 F


5/19

5

2525 2626

2727

Malignant (Necrotizing) otitis externaMalignant (Necrotizing) otitis externa

Pseudomonasaeruginosasteroid

: granulation tissue facial nerve paralysis

2828

toxin 7,9,10,11 12

parotid

2929

antibiotic aminoglycosidepenicillin

3030

Traumatic rupture of ear drumTraumatic rupture of ear drum

??

:

CSF


6/19

6

3131 3232

Wait and see Suction 1 3-10 CSF Audiogram

3333

BarotraumaBarotrauma

: Serum

Eustachial tube

3434

BarotraumaBarotrauma

..

.Decongestant Analgesic

. Valsalva

. 12

3535

(Myringotomy)

PE (Pressure equalizer) Tube

3636

Sudden hearing lossSudden hearing loss

36-50


7/19

7

3737

1. Virus, Bacteria 2. Vascular ischemia

3. Rupture window 4. Acoustic tumor

5. Intra-cochlear membrane break

6. Systemic disease: DM Aids Blood disease

7. etc

3838

3 Tinnitus 70 % Vertigo

30 dB 3

3939

Vasodilator :Vasodilator : BetahistineBetahistine diHCLdiHCLSercSerc;;BetahistineBetahistine mesylatemesylate MerislonMerislon ;;

CinnarizineCinnarizine HClHCl StugeronStugeron Steroid + Antacid

Vit. B1-6-124040

Anti-emetic drug plasil

Dimenhydrinate(Drammamine)

3 Low salt diet

4141

: : CBC, TFT, VDRL, Anti-HIV,

Blood chemistry LFT

UA

Film internal acoustic canal

4242

Nasal emergencyNasal emergency

Epistaxis

Fracture of nasal bone

Foreign body in nasal cavity

Acute infection of nose and

paranasal sinuses


8/19

8

4343

EpistaxisEpistaxis

Anterior septal bleeding

Posterior epistaxis

4444

:Kisselbachs plexusLittles area

Anter ior septal bleeding

4545

Littles area

4646

4747 4848

Vital sign

Venous pressure

5-8 Pack Adrenaline 0.1 %

or Ephedrine 1 % (HT)


9/19

9

4949

6

5050

Cold compress

Trichloracetic acid 30%

Anterior nasal packing Gel foam

Finger cot Vaseline gauze Ivalon, Surgicel

Mouth care and Rest

()

5151

Gel Foam

Finger cot

5252

Vaseline gauze packing

2

5353

Ivalon

Hydroxylated polyvinyl acetal (PVAc) sponge5454

Surgicel

FIBRILLAR Absorbable Hemostat


10/19

10

5555

Anterior nasal packing

5656

EpistaxisEpistaxis

Posterior nasal bleeding

: Juvinile Angiofibroma

Sphenopalatine artery

5757

Sphenopalatine artery

5858

5959

Vital sign, Pain cold compress

Posterior nasal packing

6060

Cold compress

Hematocrit Bleeding

mouth care

* Aspirin

Vital sign, Pain

()


11/19

11

6161 6262

6363 6464

6565

Foreign body in nasal cavityForeign body in nasal cavity

:

6666


12/19

12

6767

Nasal hook

Antibioticointment

6868

Nasal hook

6969

Fracture of Nasal BoneFracture of Nasal Bone

: Trauma:- :

: Cribriform plate CSF Dextrostick

7070

Fracture of Nasal Bone

(continue)

Fracture of Nasal Bone

(continue)

Dx : x-ray

Stop bleeding

7171

()() Close reduction

Splint5-7

Nasal packing

Deform Rhinoplasty

7272

Asch septum straightening forcepsAsch septum straightening forceps


13/19

13

7373

Walsham septum straightening forcepsWalsham septum straightening forceps

7474

Goldman displace septum elevator

7575

Acute nasal infectionAcute nasal infection

Vestibulitis

Furunculosis

Septal abscess

Complication of acute sinusitis

7676

Vestibulitis

:

:

7777

Furunculosis

:

7878

Septal abscess Septal perforation


14/19

14

7979

Antibiotic*

Cavernous sinus thrombosis

8080

Complication of acute sinusitisComplication of acute sinusitis

Periorbital abscess

Orbital cellulitis

Brain abscess

Meningitis

Cavernous sinus thrombosis

< 6

8181Paranasal sinuses 8282Sinusitis

8383

Orbital cellulitis

Orbital abscess

8484

:


15/19

15

8585

FB in upper aero-digestive tract

FB in oral cavity and oropharynx

FB in esophagus

FB in larynx and tracheobronchial tree

Peritonsillar abscess

8686

:

:

FB in oral cavity and oropharynx

8787 8888

:

8989

11.

2.

3.

4.

5. 9090

FB in esophagusFB in esophagus

::

:


16/19

16

9191

9292

Esophagoscopy

9393

FB in larynx and tracheobronchial treeFB in larynx and tracheobronchial tree

:

:

cyanosis

Cafe' coronary9494

9595 9696


17/19

17

9797

Heimlich maneuver

(Abdominal thrust or Chest thrust)

9898

Hiemlich by self

9999 100100

101101 102102Foreign bodies removed from bronchus and esophagus


18/19

18

103103

()()

wheezing

Bronchoscopy

NPO

104104

Peritonsillar abscessPeritonsillar abscess

:

105105

Abscess

Peritonsillar abscess

106106

?

107107

*

Antibiotic *

Mouth care

Analgesic* Rest

108108

Sudden stricture or collapse of tracheostomaSudden stricture or collapse of tracheostoma

Sign and symptom

Dilate stoma


19/19

109109

Tracheal Dilator or

Trousseau Tracheal Dilator

110110

Nasal speculum

111111

112112

Aphthous ulcer

113113

ent emergency 56

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