Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Chapter 25: Head, Eyes, Ears, Nose, and Throat

This chapter will discuss some of the common problems with ears, eyes, nose, throat, and teeth. Although critical system problems may be antici- pated, the chief complaint is usually more both- ersome and painful than life-threatening. Like everything else in wilderness and rescue medi- cine, the most generic and important diagnosis remains: is the problem serious or not serious? Some facial problems are best treated with antibiotics and other prescription medications. For the basic rescuer, this usually means that the patient needs to be evacuated to medical care. Practitioners with training and authorization to use prescription medications may be able to treat the problem effectively in the field. This could include emergency medical services (EMS) and search and rescue (SAR) personnel with a scope of practice extended by medical control, or the captain of a ship in communication with a medi- cal advisory service. Red Eye The most common cause is conjunctivitis, some- times called pink eye. This refers to inflammation of the thin membranous lining of the eye and the inside of the eye lids (conjunctiva). Like any other “itis” there are a number of possible causes includ- ing just about any eye problem. Conjunctivitis is

most frequently caused by a viral infection but can be the result of sunburn, foreign body, trauma, chemical irritation, or fatigue. A red eye can also be one of the symptoms of a more serious but less common condition like glaucoma, iritis, or serious bacterial infection. All the various causes of conjunctivitis produce similar symptoms. The patient will complain of an itching or burning sensation, tearing, and the eye will appear red as conjunctival blood vessels dilate in response to inflammation. There may be a small amount of eyelid swelling.

Red Eye

General Principles

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Conjunctival abrasion Corneal ulceration Corneal abrasion Glaucoma

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Foreign body Conjunctivitis Penetrating injury Etc…

conjunctivitis

Serious or Not Serious?

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In cases of red eye that are not serious the cor- nea will remain clear, the pupil will continue to react to light and vision will be unaffected except for transient blurring caused by tears or exu- date. Normal eye movements, called extraocular