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miércoles, 10 de agosto de 2016

Ocular US for the swollen traumatic eye

ALiEM
ALiEM - By Rose C, Watts M and Teisman N - August 9th, 2016
"You are caring for a patient with an incredibly swollen eye – like a scene out of almost any Rocky film. This patient is likely going to the CT scanner, but regardless of the finding (retrobulbar hematoma, orbital wall fracture, etc.) you still need to evaluate for extraocular muscle entrapment and loss of pupillary response. There’s only one problem: you can’t see the eye. The old standards like getting the patient to retract their lid using paperclips or a cotton swab may help; but sometimes there is just too much swelling, and those techniques are just not enough. Without brute force – and potentially causing more trauma – you likely won’t be able to examine this patient’s eye..."

TRICK OF THE TRADE:
Use your ultrasound to visualize both pupillary response and eye movements