Chapter 23 The Head and Face Eye Injuries

Chapter 23: The Head and Face

Eye Injuries § § § Specks in the eyes Contusions Cuts, punctures, and abrasions Blow-out fracture Hyphema Conjunctivitis Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Ear Injuries § § Cauliflower ear Swimmer’s ear Foreign bodies Tympanic rupture Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3

Nose Injuries § Epistaxis § Nasal fractures § Septal deviations Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4

Mouth and Jaw Injuries § Fractures § Temporomandibular joint injury § Injuries to teeth Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 5

Grading Concussions § Inappropriate care of concussions can have serious consequences. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 6

Glasgow Coma Scale § Observations are rated numerically. Higher scores indicate more responsiveness. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 7

Motor Response § § § Follows simple commands Localizes pain Withdraws from pain Abnormal flexion Abnormal extension No response Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 6 5 4 3 2 1 8

Eye-Opening § § Opens eyes on own Opens eyes when asked loudly Opens eyes in response to pain No response Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 4 3 2 1 9

Verbal Response (Talking) § § § Correct place, self, month, year Confused or disoriented Uses words but makes no sense Makes unknown sounds No response Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 5 4 3 2 1 10

AVPU Scale § A method to determine the level of consciousness § Alert § Verbal – responds to verbal command § Pain – responds to painful stimulus § Unresponsive Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 11

Cantu, Colorado, American Academy of Neurologists (AAN) § Three concussion grading systems, all commonly used Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 12

Grade 1 § Cantu – No loss of consciousness (LOC) – Posttraumatic amnesia (PTA) or postconcussion signs clear < 30 sec. § Colorado – Transient mental confusion – No PTA and no (LOC) § AAN – No LOC, transient confusion – Symptoms clear in < 15 minutes Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 13

Grade 2 § Cantu – LOC lasting < 1 min. and PTA or – Postconcussion signs > 30 min. and < 24 hrs. § Colorado – No LOC – Confusion with PTA § AAN – No LOC – Symptoms lasting > 15 minutes Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 14

Grade 3 § Cantu – LOC more than 1 min. or PTA > 24 hrs or – Postconcussion signs lasting > 7 days § Colorado – Any LOC § AAN – Any LOC Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 15

Brain Injuries § Brain effects constitute the most serious threats to athletes with head injuries. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 16

Subdural Hematoma § A subdural hematoma is usually the result of the tearing of small veins under the dura mater. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 17

Epidural Hematoma § Epidural hematomas are often associated with a skull fracture and arterial injury. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 18