1/7/2014 Purpose is to look for Fluid Perforations Foreign - PDF document

1/7/2014  Purpose is to look for  Fluid  Perforations  Foreign Objects  Excessive Cerumen  Inflammation  Redness  Swelling By Wayne Rodrigues, M.ED., ATC , EMT-P Cuppett, 2012  Translucent  Pearly gray in color  Concave in nature Cuppett, 2012  Otitis Media  Viral infection of the middle ear  Often accompanies upper respiratory problems  Signs and symptoms  ear pain w/out tenderness to touch, fever, pressure- feeling, loss of hearing and dizziness  Required referral and treated with antibiotics and analgesics O’Conner, 2008 http://www.hearingprofessionals.co.nz/Images/The-Human- Ear.gif 1

1/7/2014 MOI:   Growth of bacteria or fungus in MOI: outer ear resulting in outer ear   Sudden change in air pressure or infection. impaled object  Predisposing factors: dark wet S/s: environment and/or over-   Excruciating pain in middle ear that cleaning ears. radiates. Tinnitus. Marked loss of S/s:  hearing, transient dizziness.  C/c constant pain and pressure in  Blood or fluid may be viewed ear w/ associated itchiness. May escaping from the ear or viewed c/o of hearing loss, dizziness. Ear through otoscope. canal appears red and irritated  Any fluid noted in the ear canal be should be a red flag indicating upon inspection. (+) Tug Test rupture. Mgt:  Mgt:   Refer for physician evaluation www.fpnotebook.com/ EntOtomycosis.jpg  Potential for associated basilar skull  Antibiotics fx depending on MOI.  Cover with sterile gauze, and Cuppet, 2012 immediate referal.  Symptoms are similar to otitis externa:  Canal swelling & errythemia itching, pain Traumatic perforation and decrease in hearing, Subtotal perforation of the tympanic membrane  May be removed either by physician with tool or suctioning the object. http://images.medicinenet.com/images/illustrations/ear_wax.jp insect (ant) in external auditory meatus, http://stallgeriatrics.com/education/KeyPrinciple2-EarWax.jpg www.rcsullivan.com/ www/forum/zlinsky/glueear1.jpg Normal Soft  MOI: direct blow Cerumen  S/s:  May or may not have deformity but bleeding usually present. Signs of direct trauma. Ecchymosis, and swelling Impacted often present. soft brown  C/c is pain on and cerumen around the nose  MGT: ice, stop bleeding and refer Cuppett, 2012 Veil of cerumen eac.hawkelibrary.com/ 2

1/7/2014  Fungal infection involving  MOI: direct blow mucous membranes in mouth.  S/s:  Caused by fungus Candida  Same as those associated alicans which is caused from with nasal fracture. May antibiotics use and have difficulties breathing immunosuppression. through involved side.  Signs and symptoms include  MGT: creamy white plague on  Same as with nasal fracture tongue, cheeks and palate which later develop into lesions.  Treat with topical or systemic antifungal medications Cuppett, 2012 Cuppett, 2012  Gingivitis-swollen, red, or bleeding Caused by: gums  Previous surgery   Sensitivity to Hot Trauma  or Cold Beverages Cocaine Use  caused from teeth Excessive nose picking  demineralization Cancer & other diseases  http://www.blogaholics.ca/wp/uploads/illu_mouth.jpg Complications:  Halitosis (Bad  Pain, bleeding, & breath)-poor  whistling sound dental hygiene Treatment:  and periodental Small: Saline solution & disease lubricating gels  Plaque-fungal Large: Surgery infections such as http://www.webmd.com/allergies/tc/repair- candidiasis of-nasal-septal-perforation-surgery-overview http://www.acm.uiuc.edu/sigbio/project/digestive/early/mouth.jpg Pharyngitis and Tonsillitis produce  throat pain, pain swallowing, and pain in the ears when swallowing Soft painless, non  cancerous growths Pharyngitis (Strep Throat)  within nasal lining. Inspection: Erythematous in the throat with mucoid covering the Caused by:  pharynx. Inflammation, Asthma, reoccurring infections, Tonsillitis Inspection: Inflamed  tonsils immune disorder May lead to breathing  Laryngitis: causes changes in voice ,  problems, Chronic hoarseness or complete inability to infections speak. Fever or dyspnea may occur. Upon inspection may notice Treated with Meds and purulent exudate on larynx.  or surgery http://www.mayoclinic.com/health/nasal-polyps/DS00498 O’Conner, 2008 3

1/7/2014  Position patient in seated position with head turned downward and away.  Select the largest speculum that can be comfortably inserted in ear  Hold Otoscope in the same hand as the ear you examine. “Right to Right , Left to Left”  Rest ring & Little finger on patient’s cheek.  Pull the Pinna up & backwards to straighten canal  Watch your way into ear canal, never insert blindly.  Inspect the Tympanic Membrane Cuppett, 2012  Rotate speculum to view all corners of the membrane and ear canal.  Inspect the membrane for  Color  Clarity  Position  Use of Otoscope http://www.youtube.com/watch?v=FqSCfqoCNiI Cuppett, 2012 https://www.google.com/search?q=Use+of+Otoscope&client Allergies are typically  bilateral, infection is unilateral Infectious conjunctivitis  will spread quickly Treatment: Referral for  antihistamine (allergy) or antibiotics (infection) Eye infections with severe  px or photophobia may be more severe (Corneal http://www.healthanswersboard.com/blog/wp ‐ content/uploads/2008/05/pink ‐ injury or a herpes viral eye.jpg infection) O’Conner, 2008 4

1/7/2014  Blood in the anterior chamber of eye.  MOI:Forceful jarring,  Caused by blunt strong sneeze, trauma.  Signs & Symptoms: no known cause.  Pain, Bleeding  Sx: Floaters, halos,  Blurred Vision  Treatment: blind spots, http://www.kellogg.umich.edu/theeyeshaveit/trauma/images/hyphema.jpg Keep Head Elevated  curtain falling over vision http://graphics8.nytimes.com/images  Immediate referral to /2007/08/01/health/adam/9931.jpg specialist  Treatment: Referral to ophthalmologist Cuppett, 2012 O’Conner, 2008  Chronic eye disease  Bleeding under the causing central field of vision loss. conjunctiva  Caused by trauma,  Dry Degeneration forceful cough, high  More common BP, bleeding disorders  Age related  Treatment: Resolve in 1-3 weeks  Wet Degeneration  Lack of trauma =  Blood vessels under the retina begin leaking normally benign blood and fluid. O’Conner, 2008 Refer to Ophthalmologist http://www.tedmontgomery.com/the_eye/eyephotos/pics/SubconjunctivalHe https://www.google.com/search?q=macular+degeneration morrhage.jpg http://www.mayoclinic.com/health/macular- degeneration/DS00284  Most common sports eye injury  Direct trauma from outside object  Object caught and rubbed  What are the signs and symptoms http://www.eyedoctom.com/eyedoctom/EyeI https://www.google.com/search?q=macular+degeneration&clien http://www.hollows.org.au/eye-health/macular-degeneration nfo/Images/CornealAbrasion.jpg associated with this pathology? O’Conner, 2008 5

1/7/2014 http://www.youtube.com/watch?v=wPzCA9k8GRQ Cuppett, M., Walsh, K.M. (2012) General Medical Conditions in the Athlete (Second Edition) Elsevier-Mosby O'Connor, D. P., Fincher, A. L. (2008). Clinical Pathology for Athletic Trainers: Recognizing Systemic Disease (Second ed.). Thorofare, NJ: SLACK Incorporated. 6

1/7/2014 INNOCENT ABNORMAL  Common in healthy  Children’s murmurs typically caused by children heart defects at birth  Are not due to heart  Adult murmurs are problems caused by an acquired  May have been heard heart valve disease by child’s pediatrician  Typically will display as some point signs and symptoms of heart disease   Auscultation of Heart Sounds and Murmurs Cuppett, M., Walsh, K.M. (2012) General   Extra and or Unusual Sounds during a heart Medical Conditions in the Athlete (Second beat Edition) Elsevier-Mosby  Range fro very faint to load  http://www.youtube.com/watch?v=39n4XWv  May hear a swishing or whooshing sounds 7flQ  Classified as innocent(harmless) or Abnormal  http://www.nhlbi.nih.gov/health/health- http://www.nhlbi.nih.gov/health/health-topics/topics/heartmurmur/ topics/topics/heartmurmur/   http://www.youtube.com/watch?v=ax9B6g6g EOc 1