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Chapter
Chapter18Lecture
Book Title
Edition
Injuries to the Face,
Eye, and Throat
Slide Presentation prepared by
Randall Benner, M.Ed., NREMT-P
© 2012 Pearson Education, Inc.
Learning Objectives
• Describe the assessment and first aid care for a
range of eye injuries including foreign or impaled
objects, chemical burns, and eyeball, eyelid and
eye socket injuries.
• Describe the first aid care for injuries to the face,
mouth, jaw, nose, and throat, including dental
injuries.
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Injuries to the Eye
• True ocular emergencies tend to be urgent.
• Other common, and less serious, eye injuries
occur more frequently.
• Can involve underlying bone and soft tissues.
• Because of the potential for permanent damage,
never assume an eye injury is minor until
confirmed.
• All eye injuries should receive immediate
medical attention.
• Almost half of all serious eye injuries occur in the
home.
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Occurrence of Eye Injuries
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Assessment for Eye Injuries
• Check eye sockets, lids, and eyeballs for
bruising, swelling, laceration, or tenderness.
• Check for redness, pus, and foreign objects.
• Check pupils for size, shape, evenness, and
reaction to light.
• Check eye movements in all directions; look for
abnormal or paralyzed gaze, or pain with
movement.
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Basic First Aid Care for Eye Injuries
• Never put direct pressure on the eyeball.
• Don’t irrigate except for chemical burns or
foreign objects.
• Don’t put salves (ointments) or medicine in the
eye.
• Don’t remove blood or blood clots.
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Basic First Aid Care for Eye Injuries
• Don’t try to force the eyelid open except to
irrigate.
• Have the victim lie down and stay still.
• Limit use of the uninjured eye.
• Give the victim nothing by mouth.
• Get a physician’s evaluation.
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Foreign Objects in the Eye
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If not removed, can cause significant damage.
Pain is often severe.
Light may cause further irritation.
Never let a victim rub the affected eye.
Ask the victim to blink or cry to help remove
objects.
• Attempt to remove only objects that are not on or
in the cornea.
• Notify EMS.
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Removing Particles From White of the Eye
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Eye Socket Injuries
• Be aware that Facial injury may also cause
damage to skull bones.
• When an eye socket has been fractured, always
assume there is also head injury.
• Signs and symptoms include
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Double vision
Decreased vision
Loss of feeling
Nasal discharge
Paralysis of upward gaze
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Eyelid Injuries
• Include black eyes, burns, and lacerations
• Due to the profusion of blood vessels, eyelid
lacerations can cause profuse bleeding.
• Always also check for eyeball injury.
• Control bleeding and protect injured tissue and
underlying structures.
• Activate the EMS system.
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Eyeball Injuries
• Include bruising, cuts, foreign object damage,
and abrasions
• Deep lacerations can cut the cornea; if so,
eyeball contents may spill out.
• Severe blunt trauma can rupture the eyeball.
• Signs and symptoms include an irregularlyshaped eyeball, and blood in the front chamber
of the eye.
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Chemical Burns of the Eye
• Eye burns represent a dire emergency
• Permanent damage can occur within seconds
• The first ten minutes after a chemical burn injury
can determine the final outcome
• Burning and tissue damage continue while any
substance remains in the eye
• Signs and symptoms include irritation and
swelling; redness; blurred vision; extreme pain;
irritated skin around the eye
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Light Burns of the Eye
• Results from looking at ultraviolet light sources,
tanning lamps, arc welders, etc.
• Extreme pain follows one to six hours after
exposure.
• Victim should see an ophthalmologist.
• Move the victim from light sources; keep in dark
rooms.
• Cover both eyes with moist gauze pads.
• Discourage the victim from rubbing their eyes.
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Impaled Objects or Extruded Eyeball
• Should be removed only by a physician
• Stabilize the object to prevent movement.
• If serious, the eyeball may be forced out of its
socket; if so, do not attempt to replace.
• Activate the EMS immediately.
• Treat the victim for shock.
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Injuries to the Face
• Always suspect additional spinal injuries of the
neck and back.
• Establish an airway if needed; inspect the mouth
and remove fragments.
• Immobilize the neck.
• Control bleeding.
• Cover injured nerves, tendons or blood vessels
with moist, sterile dressing.
• Inspect inside and outside of the cheeks and
teeth.
• Do not use force to stop bleeding; apply gentle
pressure or just enough to stop bleeding.
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Face and Jaw Fractures
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Injuries to the Cheek and Nose
• The only time to remove an impaled facial object
is when it is in the cheek, has penetrated
through, and is loose; this presents an airway
obstruction danger.
• Nose injuries are usually caused by blunt
trauma; follow the same treatment guidelines as
for other soft-tissue injuries.
• Be careful to maintain an open airway; don’t
allow blood to drain into the throat.
• Best position for nose injury victims is usually
sitting, leaning slightly forward.
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Injuries to the Ear
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Common, but rarely life-threatening
Sections may become severed
If so, treat the same as other soft-tissue injuries.
Generally, don’t probe the ear.
Never pack the ear to prevent canal bleeding;
place a loose, clean dressing across ear
opening; don’t apply pressure.
• If you can see an embedded object, gently
remove with tweezers.
• Never irrigate to remove a foreign object; this will
cause swelling and make removal harder.
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Throat Injuries
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Can be caused by blows, constriction, falls, cuts
If cut, major artery bleeding is a serious concern
Maintaining an open airway is critical.
Have the victim lie down to reduce the chance of
air entering blood vessels.
• Position the victim on her left side, and tilt her
body downward at a 15 degree angle (head
lower than legs).
• Control bleeding.
• Treat for shock.
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Dental Emergencies
• Rarely life threatening but can be very painful
• Rapid first aid care can dramatically improve
outcomes
• In emergencies, the victim should see a dentist
or oral surgeon promptly.
• Check for and control bleeding.
• Common problems include
– Loose tooth
– Broken tooth
– Knocked-out tooth
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Summary
• Never try to remove a foreign object lodged in
the cornea or main part of the eye.
• For eyelid injuries, control bleeding but don’t
apply pressure.
• Irrigate chemical burns in eyes and seek
immediate medical help.
• With facial injuries, always suspect the
possibility of additional spinal injury.
• Top priority in treating victims of facial or jaw
injury is to maintain an open airway.
© 2012 Pearson Education, Inc.