Position supine with head elevated Truck Detailed evaluation as possible per guidelines Initiate teleconsult with photos Ultrasound contraindicated for suspected open globe injury Tetanus prophylaxis as available Tdap 05ml IM ID: 910540
Download Presentation The PPT/PDF document "Open Globe Injury Ruck Moxifloxacin 400..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Open Globe Injury
Ruck
Moxifloxacin 400 mg PO/IV if not given
Position supine with head elevated
Truck
Detailed evaluation as possible per guidelinesInitiate teleconsult with photos Ultrasound contraindicated for suspected open globe injuryTetanus prophylaxis as available (Tdap 0.5ml IM)Continue endophthalmitis prophylaxisAdditional dose of moxifloxacin 400 mg PO/IV at 12 hrsContinue moxiflxacin 400 mg PO/IV q day x 5 daysAdd clindamycin 300mg IV every 8 hours if available*Maintain patient comfort and supine/head elevated positioning
House
Guidelines for Evaluation of Suspected Open Globe Injury
Continue above treatmentsRigid eye shieldNo altitude restrictions for open globe
Plane
Critical ItemsHistory:Blast injuryMetal on metal impactBlunt trauma to ocular regionConcurrent traumaLid lacerationsPenetrating periocular traumaPhysical Exam:Visual acuityAfferent pupillary defectSuspicious findingsPeaked pupilAbnormal anterior chamber depthHemorrhagic chemosisEyelid edemaTraumatic cataractDefinitive findings:Obvious laceration/ruptureProlapsed ocular contents
Peaked pupil
Occult rupture
Abnormal anterior chamber depth
Hemorrhagic chemosis
Maintain high suspicion for open globe injury
Rigid eye shield to prevent further damage
Moxifloxacin 400mg PO/IV (
endophthalmitis
prophylaxis)Ondansetron4-8mg PO4mg IV over 2-5 min4mg IMPain control (ketamine approved)Activate evac (URGENT) Goal is surgery within 24 hours
H
ypopyon
Cloudy vitreous behind lens
Red, inflamed eye
Endophthalmitis
Endophthalmitis
Infection inside the eye
R
sk
is increased with delayed wound closure and in injuries in rural settings
Increasing pain, decreased vision
Red, angry eye,
hypopyon
, cloudy vitreous