Sports-Related Concussion/Head Injury Fact Sheet
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Prevention of Traumatic Corneal Ulcer in South East Asia
FROM OUR SOUTH ASIA EDITION Prevention of traumatic corneal ulcer in South East Asia S C AE Srinivasan/ (c)M Country Principal Investigator and Lead Principal Investigator with village health workers in Bhutan Dr. M. Srinivasan ciasis, and leprosy, are declining, and (VVHW) of the Government were utilized Director Emeritus, Aravind Eye Care, soon the majority of corneal blindness will to identify ocular injury and treat corneal Madurai, Tamil Nadu India. be due to microbial keratitis. Most abrasion corneal ulcers occur among agricultural Myanmar: Village Health Workers (VHW) workers in developing countries following of the health department Introduction corneal abrasion. India: paid village volunteers were utilized Corneal ulceration is a leading cause of Several non-randomized prevention visual impairment globally, with a dispro- studies conducted before 2000 Inclusion criteria 2 portionate burden in developing (Bhaktapur Eye Study) and during 2002 • Resident of study area countries. It was estimated that 6 million to 2004 in India, Myanmar, and Bhutan • Corneal abrasion after ocular injury, corneal ulcers occur annually in the ten by World Health Organization(WHO), have confirmed by clinical examination with countries of South East Asia Region suggested that antibiotic ointment fluorescein stain and a blue torch encompassing a total population of 1.6 applied promptly after a corneal abrasion • Reported within 48 hours of the injury billion.1 While antimicrobial treatment is could lower the incidence of ulcers, • Subject aged >5 years of age generally effective in treating infection, relative to neighbouring or historic “successful” treatment is often controls.3-4 Prevention of traumatic Exclusion criteria associated with a poor visual outcome. -
Eye Protection Health Alert Final 11 25 08.Pub
HEALTH ALERT! Keeping an Eye On Eye Protection More than 2,000 workplace eye injuries occur EVERY DAY in the United States. A vast majority of employers provide eye protection at no cost to their employees, however 94% of eyewear being used by workers is not appropriate for the job being done and about 40% of the workers receive no eye safety training on where and what type of eyewear should be used. “90% of occupational eye injuries could have been prevented if the victim was wearing proper eye and face protection” (Prevent Blindness America) The Bureau of Labor Statistics reported that 36,680 non-fatal work-related eye injuries occurred in private industry workplaces in 2004 at an estimated expense of $300 million in lost production time, medical expenses, and worker’s compensation costs. Fast Facts on Eye Injuries Eye Protection Safety Plan 9 69% of all reported facial injuries 9 Engineering Controls ~ Machine occurred to the eye. guarding, welding curtains, appropriate visible signage. 9 Nearly 70% of non-fatal eye injuries were caused by flying or falling objects 9 Administrative Controls ~ Prohibit access or sparks striking the eye. to work zones for non-workers and workers without proper safety equipment. 9 Males 25-44 years of age are at highest risk for eye injuries. 9 Personal Protective Equipment ~ Use of fitted, job specific, ANSI certified 9 The majority of eye injuries occur in protective eyewear and facewear. welders, cutters, solderers and braziers, followed by construction laborers. 9 Cleaning & Maintenance ~ Ensure proper cleaning of lens and face shields with appropriate materials and store properly to prevent damage. -
Paramedic National EMS Education Standard
NORTHWEST COMMUNITY EMERGENCY MEDICAL SERVICES SYSTEM CCCooonnntttiiinnnuuuiiinnnggg EEEddduuucccaaatttiiiooonnn SSSeeepppttteeemmmbbbeeerrr 222000111222 EEyyee && EEaarr DDiissoorrddeerrss && TTrraauummaa Questions/comments are welcome. Please direct to Jen Dyer, RN, EMT-P EMS Educator NWC EMSS Con-Ed Eye and Ear Disorders and Trauma September 2012 – page 1 Paramedic National EMS Education Standard Integrates assessment findings with principles of pathophysiology to formulate a field impression and implement a treatment/disposition plan for patients with eye and ear disorders/trauma. Objectives: Upon completion of the class and review of the independent study materials and post-test question bank, each participant will do the following with a degree of accuracy that meets or exceeds the standards established for their scope of practice: 1. Identify the anatomical structures of the eye and describe the corresponding physiologic function of each. (C) 2. Explain the physiology of normal vision. (C) 3. Identify the anatomic structures of the ear and describe the corresponding physiologic function of each. (C) 4. Explain the physiology of normal hearing. (C) 5. Explain the physiology of equilibrium. (C) 6. Select and discuss maneuvers for assessing eye structures and functions (C) and demonstrate a thorough EMS assessment of ocular structures, visual acuity, pupils and ocular movements. (P) 7. Distinguish abnormal assessment findings/conditions of the eye: blurred vision, diplopia, photophobia, changes in vision, flashing, pupil exam, Adie’s pupil, oculomotor nerve paralysis, Horner’s Syndrome, blindness, deviation/paralytic strabismus, orbit fracture, cataracts, conjunctivitis, color blindness, near sightedness, farsightedness, astigmatism, amblyopia, burns of the eye, corneal abrasions, foreign body, inflammation of the eyelid, glaucoma, hyphema, iritis, orbital cellulitis, macular degeneration and trauma. -
Differentiate Red Eye Disorders
Introduction DIFFERENTIATE RED EYE DISORDERS • Needs immediate treatment • Needs treatment within a few days • Does not require treatment Introduction SUBJECTIVE EYE COMPLAINTS • Decreased vision • Pain • Redness Characterize the complaint through history and exam. Introduction TYPES OF RED EYE DISORDERS • Mechanical trauma • Chemical trauma • Inflammation/infection Introduction ETIOLOGIES OF RED EYE 1. Chemical injury 2. Angle-closure glaucoma 3. Ocular foreign body 4. Corneal abrasion 5. Uveitis 6. Conjunctivitis 7. Ocular surface disease 8. Subconjunctival hemorrhage Evaluation RED EYE: POSSIBLE CAUSES • Trauma • Chemicals • Infection • Allergy • Systemic conditions Evaluation RED EYE: CAUSE AND EFFECT Symptom Cause Itching Allergy Burning Lid disorders, dry eye Foreign body sensation Foreign body, corneal abrasion Localized lid tenderness Hordeolum, chalazion Evaluation RED EYE: CAUSE AND EFFECT (Continued) Symptom Cause Deep, intense pain Corneal abrasions, scleritis, iritis, acute glaucoma, sinusitis, etc. Photophobia Corneal abrasions, iritis, acute glaucoma Halo vision Corneal edema (acute glaucoma, uveitis) Evaluation Equipment needed to evaluate red eye Evaluation Refer red eye with vision loss to ophthalmologist for evaluation Evaluation RED EYE DISORDERS: AN ANATOMIC APPROACH • Face • Adnexa – Orbital area – Lids – Ocular movements • Globe – Conjunctiva, sclera – Anterior chamber (using slit lamp if possible) – Intraocular pressure Disorders of the Ocular Adnexa Disorders of the Ocular Adnexa Hordeolum Disorders of the Ocular -
Corneal Abrasion
Corneal Abrasion What is a corneal abrasion? A corneal abrasion is a scratch on the surface of the clear part of the eye (cornea). It is most commonly due to trauma/injury. What are the symptoms of a corneal abrasion? Pain which can be severe Foreign body sensation Blurred vision Sensitivity to light Tearing (watering eyes) Redness What is the treatment of a corneal abrasion? Eye medication: Antibiotic drops or ointment used 3-4 times a day to prevent infection Dilating drops to decrease pain if you have a large corneal abrasion (this relieves spasm of the internal eye muscles. Please note that it will blur vision-particularly with reading.This effect may last for a few days after drop has been ceased.) Additional pain relief: Oral paracetamol, paracetamol and codeine Ice packs (place over injured eye: eyelids closed, ice pack covered in soft cloth) Sunglasses out of doors While an anaesthetic eye drop relieves immediate pain and allows the doctor to examine your eye, these drops cannot be used at home since they interfere with the natural healing of the cornea. What are the possible complications of a corneal abrasion? Infection Blurred vision from scarring Recurrent erosion syndrome: recurrent irritation from a poorly healed abrasion is most common after trauma from a sharp object such as a fingernail or paper. Corneal Abrasion Page 1 of 2 Things to remember: Most corneal abrasions heal within 3-4 days with pain improving each day until it has healed completely Do not rub your eye after the injury Do not touch your eye with cotton buds or tweezers Do not wear contact lenses until the eye has healed fully Seek medical attention if there is persistent or worsening discomfort, redness or decreased vision. -
Protocols for Injuries to the Eye Corneal Abrasion I
PROTOCOLS FOR INJURIES TO THE EYE CORNEAL ABRASION I. BACKGROUND A corneal abrasion is usually caused by a foreign body or other object striking the eye. This results in a disruption of the corneal epithelium. II. DIAGNOSTIC CRITERIA A. Pertinent History and Physical Findings Patients complain of pain and blurred vision. Photophobia may also be present. Symptoms may not occur for several hours following an injury. B. Appropriate Diagnostic Tests and Examinations Comprehensive examination by an ophthalmologist to rule out a foreign body under the lids, embedded in the cornea or sclera, or penetrating into the eye. The comprehensive examination should include a determination of visual acuity, a slit lamp examination and a dilated fundus examination when indicated. III. TREATMENT A. Outpatient Treatment Topical antibiotics, cycloplegics, and pressure patch at the discretion of the physician. Analgesics may be indicated for severe pain. B. Duration of Treatment May require daily visits until cornea sufficiently healed, usually within twenty-four to seventy-two hours but may be longer with more extensive injuries. In uncomplicated cases, return to work anticipated within one to two days. The duration of disability may be longer if significant iritis is present. IV. ANTICIPATED OUTCOME Full recovery. CORNEAL FOREIGN BODY I. BACKGROUND A corneal foreign body most often occurs when striking metal on metal or striking stone. Auto body workers and machinists are the greatest risk for a corneal foreign body. Hot metal may perforate the cornea and enter the eye. Foreign bodies may be contaminated and pose a risk for corneal ulcers. II. DIAGNOSTIC CRITERIA A. Pertinent History and Physical Findings The onset of pain occurs either immediately after the injury or within the first twenty-four hours. -
DCMC Emergency Department Radiology Case of the Month
“DOCENDO DECIMUS” VOL 4 NO 9 September 2017 DCMC Emergency Department Radiology Case of the Month These cases have been removed of identifying information. These cases are intended for peer review and educational purposes only. Welcome to the DCMC Emergency Department Radiology Case of the Month! In conjunction with our Pediatric Radiology specialists from ARA, we hope you enjoy these monthly radiological highlights from the case files of the Emergency Department at DCMC. These cases are meant to highlight important chief complaints, cases, and radiology findings that we all encounter every day. Conference Schedule: September 2017 If you enjoy these reviews, we invite you to check out Pediatric Emergency Medicine 6th - 9:00 Asthma……………………………….……..…Dr Ryan 10:00 Sports Meds/MSK Disorders……………Dr Santelli Fellowship Radiology rounds, which are offered 11:00 QI Improvement………..……………………….Dr Iyer 12:00 ECG Series…………..Dr Yee & Electrophysiologist quarterly and are held with the outstanding support of the Pediatric Radiology specialists at 13th - 10:00 FTT/Feeding Problems in the ED……Dr Whitaker 11:00 Lac Repair/Plastics………..…Dr Kienstra/Salinas Austin Radiologic Association. AAP Meeting: 16 - 19 If you have and questions or feedback regarding 20th - 9:00 Chronic Abdominal Pain…………….…Dr Siddiqui 10:00 Toxicology…………………..Dr Friesen/Arredondo the Case of the Month format, feel free to 11:00 Populations and Sampling…………..Dr Wilkinson email Robert Vezzetti, MD at 12:00 ED Department Meeting [email protected]. 26th - Journal club 27 - 9:00 M&M…………………..………..…Dr Schwartz/Schunk This Month: Pediatric eye injuries can be devastating. 10:00 Board review: Neurology……………….Dr Whitaker Often, imaging is employed to evaluate the extent of an 12:00 Research Update…………..………..….Dr Wilkinson injury and is used as a pre-operative measure to give a sub Guest Speaker: Dr Anees Siddiqui, Pediatric Gastroenterology specialist a good idea of the anatomy involved in the Dell Children’s Medical Center, SFC injury. -
Week of July 27, 2015 – Eye Injuries Protecting Your Eyes from Injury Is
Week of July 27, 2015 – Eye Injuries Protecting your eyes from injury is one of the most basic things you can do to keep your vision healthy throughout your life. And the most basic step a person can take to protect his/her eyes is wearing the proper protective eyewear. According to a national survey by the American Academy of Ophthalmology, only 35 percent of respondents said they always wear protective eyewear when performing home repairs or maintenance; even fewer do so while playing sports. Eye emergencies include: cuts, scratches, getting objects in the eye, burns, chemical exposures, and blunt injuries to the eye or eyelid. Certain eye infections and other medical conditions, such as blood clots or glaucoma, also represent serious conditions. Since the eye is easily damaged, any of these conditions can lead to vision loss. A black eye is a bruise and usually caused by direct trauma to the eye or face. The bruise is caused by bleeding under the skin. The tissue around the eye turns black and blue, gradually, over a few days, it changes to purple, green, and yellow. The abnormal color disappears within 2 weeks. Swelling of the eyelid and tissue around the eye may also occur. Certain types of skull fractures may also result in bruising around the eyes, even without direct injury to the eye. Sometimes, serious damage to the eye itself occurs from the pressure of a swollen eyelid or face and can result is a hyphema; which is blood in the front area of the eye. Trauma is a common cause of the condition and is often due to a direct hit to the eye from a ball. -
Part I Biopharmaceuticals
1 Part I Biopharmaceuticals Translational Medicine: Molecular Pharmacology and Drug Discovery First Edition. Edited by Robert A. Meyers. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA. Published 2018 by Wiley-VCH Verlag GmbH & Co. KGaA. 3 1 Analogs and Antagonists of Male Sex Hormones Robert W. Brueggemeier The Ohio State University, Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Columbus, Ohio 43210, USA 1Introduction6 2 Historical 6 3 Endogenous Male Sex Hormones 7 3.1 Occurrence and Physiological Roles 7 3.2 Biosynthesis 8 3.3 Absorption and Distribution 12 3.4 Metabolism 13 3.4.1 Reductive Metabolism 14 3.4.2 Oxidative Metabolism 17 3.5 Mechanism of Action 19 4 Synthetic Androgens 24 4.1 Current Drugs on the Market 24 4.2 Therapeutic Uses and Bioassays 25 4.3 Structure–Activity Relationships for Steroidal Androgens 26 4.3.1 Early Modifications 26 4.3.2 Methylated Derivatives 26 4.3.3 Ester Derivatives 27 4.3.4 Halo Derivatives 27 4.3.5 Other Androgen Derivatives 28 4.3.6 Summary of Structure–Activity Relationships of Steroidal Androgens 28 4.4 Nonsteroidal Androgens, Selective Androgen Receptor Modulators (SARMs) 30 4.5 Absorption, Distribution, and Metabolism 31 4.6 Toxicities 32 Translational Medicine: Molecular Pharmacology and Drug Discovery First Edition. Edited by Robert A. Meyers. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA. Published 2018 by Wiley-VCH Verlag GmbH & Co. KGaA. 4 Analogs and Antagonists of Male Sex Hormones 5 Anabolic Agents 32 5.1 Current Drugs on the Market 32 5.2 Therapeutic Uses and Bioassays -
New Information from MSA Safety Works Regarding EPA Lead Requirements for Remodelers
New Information from MSA Safety Works Regarding EPA Lead Requirements for Remodelers Safety Products for Remodelers for Lead Exposure Protection during Renovation, Repair and Painting Renovation of older structures can create hazardous lead dust and Personal Protective Equipment chips within those environments by disturbing lead-based paint. In • Eyewear (MSA recommends ANSI-compliant safety glasses or response to the need to help prevent lead poisoning, in 2008 the U.S. goggles - see below) Environmental Protection Agency (EPA) issued a rule requiring use of • Painters’ hats lead-safe practices, as common renovation activities such as sanding, • Gloves cutting, and demolition can create serious lead exposure hazards. • Coveralls • Disposable shoe covers As of April 22, 2010, the EPA requires that contractors performing • N-100-rated disposable respirators (MSA recommends renovation activities that disturb lead-based paint in pre-1978-built P-100 rated respirators – see below) homes, child-care facilities, and schools must be certified and must follow specific work practices aimed at preventing lead contamination. The “eyewear” referred to by the EPA comprises safety glasses or Contractors must document compliance with this requirement and goggles compliant to the latest American National Standards Institute provide certification to customers when asked to do so. Z87.1 standard. If remodelers remove lead paint with chemical strippers, chemical splash goggles (ANSI-compliant goggles with Contractors performing work in homes, child-care -
Evaluating Residential Indoor Air Quality Concerns1
Designation: D7297 – 06 Standard Practice for Evaluating Residential Indoor Air Quality Concerns1 This standard is issued under the fixed designation D7297; the number immediately following the designation indicates the year of original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A superscript epsilon (´) indicates an editorial change since the last revision or reapproval. 1. Scope 2. Referenced Documents 1.1 This standard practice describes procedures for evaluat- 2.1 ASTM Standards:2 ing indoor air quality (IAQ) concerns in residential buildings. D1356 Terminology Relating to Sampling and Analysis of 1.2 The practice primarily addresses IAQ concerns encoun- Atmospheres tered in single-family detached and attached (for example, D1357 Practice for Planning the Sampling of the Ambient townhouse or duplex design) residential buildings. Limited Atmosphere guidance is also included for low- and high-rise multifamily D4861 Practice for Sampling and Selection of Analytical dwellings. Techniques for Pesticides and Polychlorinated Biphenyls 1.3 The IAQ evaluation procedures are comprised of inter- in Air views with the homeowner or resident(s) (including telephone D4947 Test Method for Chlordane and Heptachlor Residues interviews and face-to-face meetings) and on-site investiga- in Indoor Air tions (including walk-through, assessment, and measure- D5197 Test Method for Determination of Formaldehyde ments). For practicality in application, these procedures are and Other Carbonyl Compounds in Air (Active Sampler dividing into three separate phases. Methodology) 1.4 The procedures described in this standard practice are D5438 Practice for Collection of Floor Dust for Chemical aimed at identifying potential causes contributing to the IAQ Analysis concern. -
Diagnosing Depressed Skull Fracture in a Young Child
Nursing Practice Keywords: Skull fracture/Children/ Neurology Case study Neurology Skull fractures associated with intracranial injury are a leading cause of traumatic death in childhood. Children with head injuries should be monitored for signs of deterioration Diagnosing depressed skull fracture in a young child respiratory rate 32/min and oxygen satura- In this article... tion 97% in air. He was drowsy but easily Risks associated with head injury and skull fracture roused by his parents. The Glasgow Coma Scale score was 12/15, which could indicate The importance of monitoring and early diagnosis an intracranial injury and raised intracra- nial pressure. A neurological examination revealed Authors Shameem Ahmed is assistant left-sided hemi-paresis indicative of raised professor in neurosurgery; Rupa Thenseen intracranial pressure. A right-sided lateral Frank is sister in charge, neurosurgical soft tissue swelling and haematoma along operation theatre; both at Gauhati Medical with a depression of the underlying bones College, Guwahati, India; Siba Prosad Paul was noted on palpation of his skull. is specialty trainee in neonates at South- He was reviewed by an anaesthetist and mead Hospital, Bristol his condition was considered to be stable. An urgent non-contrast computed tomog- ead injury is the most common raphy scan revealed a large depressed frac- cause of death and disability in ture (>5mm) involving the right fronto- people aged below 40 years parieto-occipital bone (Fig 1). The boy was H(National Institute for Health Fig 1. Large right fronto-parieto-occipital reviewed by the neurosurgical team and an and Care Excellence, 2014). It accounts for bone simple depressed fracture exploration and elevation of the depressed 1.4 million attendances at accident and fragment was carried out on the same day.