Eye Trauma.

Scratched eye (corneal abrasion)

ExpandableEye lacerations usually require emergency care. Don’t hesitate to visit an optician immediately.

 

A corneal abrasion is a scratch on the clear front surface of the eye. Causes include getting poked in the eye or rubbing the eye when a foreign body is present, such as dust or sand. Corneal abrasions are very uncomfortable and cause eye redness and sever sensitivity to light

If you know something has scratched your eye, it’s important to see your optician or go to an emergency room or A&E to seek immediate treatment for your eye injury.

Scratches also can make your eye susceptible to infection from bacteria or a fungus. Certain types of bacteria and fungi can enter the eye through a corneal abrasion and cause serious harm in as little as 24 hours. Even blindness can result. This is especially true if whatever scratched your eye is dirty or contaminated. For example, corneal abrasions caused by a baby’s fingernails or tree branches can cause a serious eye infection.

If you have a scratched eye, don’t rub it. And don’t patch your eye, either. Bacteria like dark, warm places to grow, and a patch might provide the ideal environment. Simply keep the eye closed or loosely tape a paper cup or eye shield over it. See your optician as soon as possible to check out this type of eye injury.

Penetrating or foreign objects in the eye

If a foreign object such as metal or a fish hook penetrates your eye, see an optician or go to an A&E medical facility immediately. You could cause even more injury to your eye if you attempt to remove the object yourself or if you rub your eye.

If possible, try loosely taping a paper cup or eye shield over your eye for protection; then seek help.

Your eye also may have corneal foreign bodies that are small, sharp pieces of a substance (usually metal) that have become embedded in the eye’s surface (cornea), but have not penetrated into the interior of the eye.

Metal foreign bodies can quickly form a rust ring and a significant scar. Your Doctor (GP) should remove these foreign bodies as soon as possible.

Chemical eye injury

Getting unexpectedly splashed or sprayed in the eye by substances other than clean, harmless water can be scary. Some substances burn or sting but are fairly harmless in the long run, while others can cause serious injury. The basic makeup of the chemical involved can make a lot of difference, such as:

  • Acid. As a general rule, acids can cause considerable redness and burning but can be washed out fairly easily.
  • Alkali. Substances or chemicals that are basic (alkali) are much more serious but may not seem so because they don’t cause as much immediate eye pain or redness as acids. Some examples of alkali substances are oven cleaners, toilet bowl cleaners and even chalk dust.

 

Chemical exposures and burns are usually caused by a splash of liquid getting in your eye. But they can be caused in other ways as well, such as by rubbing your eyes and transferring a chemical from your hands to your eyes or by getting sprayed in the eye by hair spray or other aerosols.

If you’re splashed in the eye, put your head under a steady stream of barely warm tap water for about 15 minutes. Just let it run into your eye and down your face.

Then visit your optician or A&E department to see what additional care is recommended for your eye injury. Tell the person on the phone exactly what kind of substance got into your eye and what you’ve done about it so far.

If you know your eye is at risk because it’s extraordinarily red or blurry, then just go immediately to your optician or an A&E department after you’ve rinsed it with water. You can put a cool, moist compress or an ice pack on your eye, but don’t rub it.

Depending on the substance, the effects of chemical exposures causing eye injuries can range from minor irritation and red eyes to serious eye damage and even blindness.

Eye swelling

Eye swelling and puffy, swollen eyelids can result from being struck in the eye by any fast-moving object.

The best immediate treatment for this type of eye injury is an ice pack.

You may have a simple black eye (bruising around the eye), but you should see an optician to make sure there’s no internal damage.

Subconjunctival hemorrhage (eye bleeding)

This eye injury usually looks worse than it really is. A haemorrhage involves leakage of blood from one or more breaks in a blood vessel that lies between the white of the eye (sclera) and its clear covering (conjunctiva).

Subconjunctival hemorrhages are quite common and can occur from even minor injury to the eye. They may be limited to a small sector of the eye, or they can extend over the entire eye, making the white sclera appear bright red.

A subconjunctival hemorrhage is painless and does not cause temporary or permanent vision loss. No treatment is required. Over the course of several weeks, the blood will clear and the eye will return to a normal appearance.

Traumatic iritis

Traumatic iritis is inflammation of the coloured part of the eye that occurs after an eye injury. Traumatic iritis can be caused by a poke in the eye or a blow to the eye from a blunt object, such as a ball or a hand.

Traumatic iritis usually requires treatment. Even with medical treatment, there is a risk of permanent decreased vision.

Hyphema and orbital blowout fracture

A hyphema is bleeding in the anterior chamber of the eye, the space between the cornea and the iris.

Orbital blowout fractures are cracks or breaks in the facial bones surrounding the eye.

Hyphemas and blowout fractures are serious eye injuries and medical emergencies. They are caused by significant blunt force trauma to the eye and face.

Steps to take after an eye injury

If you have any eye injury, contact your optician immediately or go to an A&E department right away for advice.

Once you are in professional care, be sure to mention if you wear contact lenses. so you can be advised whether to leave them in or remove them.

Depending on the type of eye injury, they may want you to flush your eye with water or saline solution. In more serious situations, you may need surgery.

Treat all eye injuries as potential emergencies, and never hesitate to contact or see an optician immediately. Don’t take risks with your eyesight. Remember, you have only one pair of eyes.

Chest Trauma (Flail Chest)

Flail Chest

What is Flail Chest?

Flail chest describes a situation in which a portion of the rib cage is separated from the rest of the chest wall, usually due to a severe blunt trauma, such as a serious fall or a car accident. This affected portion is unable to contribute to expansion of the lungs, which creates some obvious problems for the patient (hampered breathing) and can contribute to some not-so-obvious ones. Flail chest is a serious condition that can lead to long-term disability and even death.

When facing someone with flail chest, the goal of emergency room personnel is to stabilize the chest wall, followed by identification and treatment of all injuries in and around the chest. The significance of flail chest is it suggests the presence of underlying cuts and bruises on the lungs. After all, broken ribs have pointed, sharp or jagged edges. The injured ribs probably were knocked out of place and possibly against or into the lungs by the trauma. And proper breathing, of course, remains a critical consideration.

The Mechanics of Flail Chest

For a person to draw a breath, the muscles around the rib cage and the diaphragm have to move to expand the chest cavity. This creates a vacuum that is filled as air enters the lungs. If this expansion is hindered, the ability to draw air into the lungs is diminished. A flail chest is a chest in which sections of broken ribs are isolated from, and interfering with, normal chest movements. That means the chest cannot expand properly and cannot properly draw air into the lungs.This is why stabilization after blunt trauma is important. Not only are the ribs themselves in need of attention, but their condition, position and inability to function properly is causing other, potentially more serious matters that must be addressed quickly. Doctors agree that it is the potential underlying injury to the lungs, and not the flail chest segment itself, that is the most pressing and life-threatening concern.

Symptoms of Flail Chest

The strict requirement for a diagnosis of flail chest—at least three ribs close together broken in two or more places—can be confirmed only by taking an x-ray. But all other significant symptoms can be observed through a simple physical exam.The most telling symptom is paradoxical movement of a portion of the chest wall—that is, the affected area draws in when the patient breathes in and the rest of the chest expands, and the affected area moves outwards as the patient exhales and the rest of the chest contracts. Paradoxical movement is an obvious sign that the portion of the chest wall is not assisting with the breathing function.

Other symptoms of flail chest can include:

  • Bruises, grazes, and/or discoloration in the chest area
  • Telltale markings from a seat belt
  • Chest pain
  • Difficulty drawing breath

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Resuscitation Guidelines as per the ERC

When cardiac arrest occurs, systems and education should be in place to ensure that:

  • cardiac arrest is recognised early,
  • help is sought – shout for nearby help and dial 999,
  • CPR is promptly started according to current guidelines,
  • an AED is located, retrieved and used as early as possible.

These interventions can be performed with guidance from the 999 call taker including: instructions for confirming cardiac arrest, starting compression-only CPR, and locating, retrieving and using an AED.

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Haemorrhagic Stroke

A stroke occurs when blood flow to an area of the brain is cut off. When this happens the brain cells are deprived of oxygen and begin to die.

A hemorrhagic stroke is when blood from an artery begins bleeding into the brain. This happens when a weakened blood vessel bursts and bleeds into the surrounding brain.

Pressure from the leaked blood damages brains cells, and, as a result, the damaged area is unable to function properly.

Causes

There are two main types of hemorrhagic stroke:

[x-ray illustration of a stroke]
A hemorrhagic stroke occurs when a weakened blood vessel bursts, leaking blood into the brain.
  • Intracerebral hemorrhage: The bleeding occurs inside of the brain. This is the most common type of hemorrhagic stroke.
  • Subarachnoid hemorrhage: The bleeding occurs between the brain and the membranes that cover it.

Both types of hemorrhagic stroke have the conventional stroke risk factors.

In addition, the risk factors for intracerebral hemorrhage include:

  • Hypertension is the most common cause
  • Cerebral cavernous malfunctions – when blood vessels do not form correctly in the brain.
  • Arteriovenous malformations (AVMs) – a genetic condition where blood vessels form incorrectly, leading to an abnormally tangled web.

AVMs typically occur in the brain and spine. If they occur in the brain, the vessels can break, leading to bleeding into the brain. This disorder is rare.

Risk factors for subarachnoid hemorrhage are most often:

  • AVMs
  • bleeding disorders
  • head injury and trauma
  • blood-thinning medication
  • a bulge in the wall of a blood vessel called a cerebral aneurysm

An aneurysm can increase in size, causing the artery wall to weaken. If an aneurysm bursts, uncontrolled bleeding may occur.

 

Symptoms
[older man exhibiting signs of a stroke]
Symptoms include confusion, loss of speech, sudden headache, and loss of coordination.

Symptoms of a hemorrhagic stroke can vary, but common signs include:

  • sudden severe headache
  • vision changes
  • loss of balance or coordination
  • becoming unable to move
  • numbness in an arm or leg
  • seizures
  • loss of speech or difficulty understanding speech
  • confusion or loss of alertness
  • nausea and vomiting
  • loss of consciousness

Additional symptoms of either type of hemorrhagic stroke include:

  • paralysis or numbness in any part of the body
  • inability to look at bright light
  • stiffness or pain in the neck area
  • hand tremors
  • frequent fluctuation in the heartbeat and breathing
  • difficulty swallowing

Complications

In addition to other medical problems, a stroke can cause temporary or permanent disability. This depends on how long blood flow to the brain was interrupted and which part of the brain was affected.

Possible complications include:

  • blood clots
  • difficulty swallowing or talking
  • pneumonia
  • loss of bladder control
  • memory loss or thinking difficulties
  • pain
  • emotional problems
  • brain swelling
  • seizures
  • depression

Act FAST

– Face, Arms, Speech, Time,

Airway Obstruction, Adults and Children

Both adults and children may be victims of choking. It is essential to recognise what is happening. The context may provide important clues. For example, choking is common at mealtimes, or a child may have been playing with small objects.

The victim may go silent and hold or point to their throat. If the obstruction to the airway is only partial, the victim may be able to speak, cough and breathe. Encourage them to cough and clear the obstruction but keep a close eye on them to make certain that the situation does not get worse.

If the airway is severely obstructed, the victim will not be able to talk, but may be able to respond by nodding or shaking their head. Coughing will be ineffective, breathing will be difficult, noisy or, at worst, impossible. Without treatment the victim will ultimately lose consciousness.

Severe airways obstruction is treated by measures that aim to increase the pressure inside the chest and thereby expel the obstruction.

Learn how to manage a casualty suffering from an airway obstruction.
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W: www.mcpfirstaidtraining.co.uk