Episode 7: See No Evil, Hear No Evil, Speak No Evil

See No Evil, Hear No Evil, Speak No Evil

Featured Guests: Dr. Blase Kania, Dr. Sarah Lee, & Dr. Patrick Kettyle

Hosts: Dr. Shorok Hassan & Dr. Danielle Langan

Top Takeaways:

Lateral Canthotomy:

1) Indications: elevated IOP >40 in the setting of trauma & decreased visual acuity.

2) Always prepare! Get your sterile drape, sterile towels, lidocaine with epinephrine, syringes for irrigation, gauze, a hemostat/kelly clamp, scissors, and forceps.

3) When anesthetizing the eye, always remember to aim the needle AWAY from the orbit.

4) Recheck IOP and visual acuity 5 minutes after cutting inferior crus. If no improvement, proceed to cutting superior crus.

Auricular Hematoma:

1) Keep your patient comfortable by numbing with a ring block around the ear.

2) Incision & drainage > needle aspiration, having lower chances of hematoma recurrence.

3) Suture a bolster dressing to patients to prevent hematoma from reaccumulating.

4) Give rapid ENT follow up!

Jaw Reduction:

1) Atraumatic jaw dislocations don’t require imaging before reduction, while traumatic dislocations require a CT maxillofacial performed before attempting to reduce the jaw.  

2) Choosing a technique for a jaw reduction is largely dependent on your patient. Get a feel for what your patient would be willing to tolerate before choosing to do procedural sedation or choosing a technique.

3) Don’t waste time stacking tongue depressors in a patient’s mouth to “tire out the jaw muscles,” just pick your method and get the job done.

4) Do your best to avoid procedural sedation: use morphine and other medications for anxiolysis instead.