Blast Eye Injuries: A Review for First Responders

2010 ◽  
Vol 4 (2) ◽  
pp. 154-160 ◽  
Author(s):  
Michael G. Morley ◽  
Jackie K. Nguyen ◽  
Jeffrey S. Heier ◽  
Bradford J. Shingleton ◽  
Joseph F. Pasternak ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Foreign Bodies ◽  
Vision Loss ◽  
Injured Patient ◽  
Ocular Injury ◽  
Blast Injuries ◽  
Care Providers ◽  
Eye Injuries ◽  
Open Globe ◽  
Severe Vision Loss

ABSTRACTAs the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.(Disaster Med Public Health Preparedness. 2010;4:154-160)

scholarly journals Adapting to Health Change: Aging Bias, Sensitivity, and Interprofessionalism in an Aging Sensitivity Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 882-883
Author(s):  
Keith Kleszynski ◽  
Lee Jennings ◽  
Thomas Teasdale ◽  
Carrie Ciro ◽  
Carol Rogers ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Interprofessional Education ◽  
Vision Loss ◽  
Medication Management ◽  
Care Providers ◽  
Age Related ◽  
High Satisfaction ◽  
Small Change ◽  
Aging Attitudes ◽  
Age Related Changes

Abstract Adapting to Health Change, a 2-hour aging sensitivity simulation to increase student sensitivity to age-related changes, was delivered to 148 health professions students in March 2020. Five small group stations (hearing loss, neuropathy and dexterity, vision loss and medication management, language and cognitive impairment, and mobility and balance) were facilitated by older adult volunteers and interdisciplinary faculty. Students completed (pre-post) Aging IQ Quiz, Aging Attitudes Assessment, Inter-professional Attitudes Scale (IPAS) Teamwork, Roles, and Responsibilities and Interprofessional Biases subscales, and an overall satisfaction rating. There was a statistically significant but small change in perceived knowledge of aging (mean Aging IQ score changed -0.025 points, p = 0.03). We also found a post-training increase in negative bias (mean Aging Attitudes Assessment score changed +2.68 points, p = 0.0001). While there was no change in attitudes about interprofessional education, this wasattributed to high baseline scores, suggesting students already valued interprofessional interactions. Multiple high satisfaction scores were encouraging. Ninety-four percent agreed that the simulation increased their understanding of age-related changes, while 97% indicated facilitators provided useful insights into the experiences of aging. A high majority (89%) felt they would be better health care providers for older patients than they would have been without the experience. This exercise to increase student empathy about age-related disabilities was well received, but did not achieve the usual intended aims. Simulation content should “re-aim” beyond empathy to teach new knowledge, highlight positive aspects of aging and professional care provision, and reinforce interprofessional roles toward wellness for older adults.

scholarly journals The Low Vision Rehabilitative Service, Part One: Understanding Low Vision

2003 ◽  
Author(s):  
Joseph Pizzimenti
Keyword(s):  
Health Care Providers ◽  
Allied Health ◽  
Vision Loss ◽  
Low Vision ◽  
Instructional Program ◽  
Background Information ◽  
Care Providers ◽  
Rehabilitation Team ◽  
Vision Rehabilitation ◽  
The Impact

Allied health professionals are becoming increasingly adept at identifying persons that are living with low vision. Low vision rehabilitation is among the emerging areas of practice for various allied health care providers. This paper, the first of a two-part feature, provides background information that will help the allied health professional to better understand the person who will be receiving these services. The paper discusses the impact of functional vision loss, and presents a four-phase, interdisciplinary model of low vision services that can be applied to any setting, whether clinical or non-clinical. Finally, this paper describes the potential roles of the various members of the vision rehabilitation team. Part two of this series, to be presented in a subsequent publication, shall focus on methods of assessing low vision, providing clinical services, and establishing an adaptive training and instructional program.

scholarly journals Characteristics of eye injuries in urban KwaZulu-Natal Province, South Africa: 2005-2008

2013 ◽  
Vol 72 (3) ◽  
Author(s):  
V.N. Sukati ◽  
R. Hansraj
Keyword(s):  
South Africa ◽  
Blunt Trauma ◽  
Age Groups ◽  
Epidemiological Data ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Solid Objects ◽  
Open Globe ◽  
Kwazulu Natal ◽  
Ocular Injuries

Purpose:   To provide epidemiological data on ocular injuries among patients utilising the provincial hospitals eye care clinics in urban KwaZulu-Natal, South Africa.  This data can be used in the future planning and intervention for ocular injuries at provincial hospitals.Methods:  Record cards of 220 ocular injury patients seen at two selected urban provincial hospitals over a period of four years were reviewed.Results:   Male presentation was higher (79.1%) compared to females (20.9%). The  Black  population (85.9%) experienced more ocular injuries than other race groups.  The 21 to 30 age group incurred more injuries (32.3%) than other age groups.  Open globe injuries occurred more frequent (56.4%) than closed globe injuries (43.6%).  The frequent type of injury was blunt trauma/contusion (32.7%).  More than half of the injuries were from solid objects (56.4%) followed by assaults (16.4%).  The home was the common place to incur an injury (72.2%).  Twenty four patients (10.9%) required surgical intervention at initial presentation.  One hundred and fifty eight (71.8%) patients returned for follow up examination.  Twenty five percent of the patients remained with poor vision following treatment.  Conclusion:   Ocular trauma due to burns is usually bilateral while that due to blunt trauma and intra ocular foreign bodies are generally unilateral.  Solid objects were the most frequent cause of ocular injury and injuries due to this cause were most often incurred in the home. (S Afr Optom 2013 72(3) 119-126)

scholarly journals Profile of Ocular Trauma Patients presenting to the National Eye Referral Hospital, Asmara, Eritrea

2021 ◽  
Author(s):  
Oluwafemi Adekunmi Ibrahim ◽  
Danait Michael ◽  
Hermela Misghna ◽  
Amir Ibrahim ◽  
Rut Russom
Keyword(s):  
Ocular Trauma ◽  
Visual Outcome ◽  
Referral Hospital ◽  
Ocular Injury ◽  
Trauma Patients ◽  
Open Globe Injury ◽  
Eye Injuries ◽  
Cross Sectional ◽  
Open Globe ◽  
At Home

Abstract Background Ocular trauma is a significant disabling health problem and a leading cause of visual impairment and loss worldwide. These injuries have many diverse costs including human suffering, long term disabilities, loss of productivity and economic hardship. Therefore, assessing the profile of ocular trauma, the etiology and its outcome is critical to the prevention of ocular injuries Methods This cross-sectional study was conducted on ocular trauma patients presenting to Berhan Ayni National Eye Referral Hospital from August – November, 2018. Data on demography, presenting visual acuity, type of injury and visual outcome were collected using a standardized questionnaire. The types of injuries were classified according to Birmingham Eye Trauma Terminology System. Pearson Chi-Square test (χ2)/or Fisher’s exact test in the Crosstab procedure was used to evaluate the relationship between specific variables. Logistic regression models were constructed to assess risk factors associated with blindness. Result 280 patients were seen with ocular trauma in the hospital during the study period. Males were 198 (70.7%) and peak age was 18–40 years. Ocular injury commonly occurred at home (31.8%), street and high way (31.4%) and workplace (28.9%). 24.7% of the injury was work-related. Common causes of injury were blunt objects (37.5%), sharp objects (31.1%) and fall (12.5%). 27.8% had open globe injury (OGI). Blindness was associated with rural residence (p < 0.0001), presentation greater than 24 hours (p = 0.04), non-use of eye protection goggles (p = 0.007), open globe injury (p = 0.018), posterior segment involvement (p < 0.0001) and hospitalization (p < 0.0001). Conclusion Immediate and comprehensive medical care is mandatory for ocular trauma patients. Educating the public especially at home and workplace is essential to prevent eye injuries.

Management of Intraocular Foreign Bodies of the Posterior Segment to Maximize Anatomical and Functional Outcomes

2021 ◽  
pp. 333-340
Keyword(s):  
Functional Outcomes ◽  
Foreign Bodies ◽  
Vision Loss ◽  
Crystalline Lens ◽  
Posterior Segment ◽  
Special Treatment ◽  
Open Globe Injury ◽  
Open Globe ◽  
Treatment Considerations ◽  
Complicated Situation

Open globe injury (OGI) repair remains one of the most challenging surgeries in all of the eye surgery. Intraocular foreign bodies (IOFBs) constitute a subset with special treatment considerations. It is also clear that these operations can create a more complicated situation due to damage to the cornea or crystalline lens to ensure the safe removal of the posterior segment IOFBs. In these operations, indications, time, and surgical technique of removal of the IOFB should be planned in detail to maximize anatomical and functional success and prevent permanent vision loss of the patient. Several controversies exist in the management of IOFBs that will be reviewed in this article.

scholarly journals Successful Transabdominal Removal of Penetrating Iron Rod in the Rectum: A Case Report

2021 ◽  
Vol 5 (2) ◽  
pp. 137-141
Author(s):  
Jay Lodhia ◽  
David Msuya ◽  
Kondo Chilonga ◽  
Danson Makanga
Keyword(s):  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Primary Repair ◽  
Sexual Pleasure ◽  
Emergency Laparotomy ◽  
Care Providers ◽  
Emergency Physicians ◽  
Sex Toys

Foreign bodies in the anus and rectum are not uncommon presentations globally. Reasons for foreign bodies in the rectum can be trauma, assault, psychiatric reasons but the most common reason documented is sexual pleasure, and objects range from sex toys to tools to packed drugs. Regardless of the reason, health care providers must maintain nonjudgmental composure and express empathy. Numerous cases have been reported of anorectal foreign body due to various causes. Removal of the objects has mostly been through rectally but some does need surgical intervention. A multidisciplinary approach and radiologic investigations are important to guide in the management outline. Establishment of guidelines for anorectal foreign bodies are needed to guide surgeons and emergency physicians on the course of treatment. We present a case of an eleven-year old school boy slid and fell on an iron rod that penetrated his rectum through his anal canal. Presented with clinical features of peritonitis, where emergency laparotomy was done and the iron rod was extracted abdominally with primary repair of the rectum. The boy recovered well and was discharged four days after with no complications.

Clinical presentation and visual outcome of broomstick ocular injury in 120 eyes of children at a tertiary eye care in India

2020 ◽  
Author(s):  
Abhishek Gupta ◽  
Prabhakar Singh ◽  
Richa Gupta ◽  
Vidya Bhushan ◽  
Shivani Sinha ◽  
...  
Keyword(s):  
Ocular Trauma ◽  
Hand Movement ◽  
Visual Outcome ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Early Presentation ◽  
Open Globe ◽  
Regional Institute ◽  
Open Globe Injuries

Abstract Background Eye injuries are a serious health problem globally. Ocular trauma accounts for 5% of blindness cases. In India broomstick injury is very common. But only few studies are published regarding the nature and outcome of broomstick ocular injuries. The aim of this study is to determine the frequency, mode of presentation, complications and surgical results with a view to offering solutions to reduce this trend. Methods This retrospective study was conducted at Regional Institute of Ophthalmology, Patna. The records of all patients presenting to the Eye OPD and Emergency clinic with ocular trauma from broomstick injury between March2017 and April 2020 were reviewed. A total of 120 cases were identified. Patient’s age, gender, interval between injury and presentation to eye OPD, mechanism of injury, activity at time of injury, visual acuity at presentation, anterior and posterior segment findings, diagnosis, complications, treatments offered and follow-up events were documented. Data were analysed statistically. Results The mean age of presentation was 8.10 ± 4.93 years. All were children < 15 years old. 80% patients sustained trauma from broomstick shot as an arrow. 70% had presenting vision < Hand movement. 90% of the cases were open globe injuries. Most of them had multiple complications such as corneal perforation (80%), traumatic cataract (27%), endophthalmitis (68%), retinal detachment (12.5%), panophthalmitis 8 (7%) and orbital cellulitis (6%). Culture was positive in 20%. Pseudomonas aeuroginosa was the most common organism isolated. Therapeutic vitrectomy was performed in 67% eyes. Only 12% eyes gained ambulatory vision (VA > 3/60) after vitrectomy. Conclusion Broomstick shot as an arrow causes devastating and multiple complications resulting in rapid and immediate loss of vision. Overall prognosis is bad and early presentation to the hospital does not appear to improve the prognosis. Such injuries often affect younger, male children. Primary prevention is the only way to control blindness occurring from such injuries. Primary health education should be given in school to highlight these risk factors.

scholarly journals Pseudomonas aeruginosa endophthalmitis caused by accidental iatrogenic ocular injury with a hypodermic needle

2017 ◽  
Vol 45 (2) ◽  
pp. 882-885
Author(s):  
Cheng-wei Lu ◽  
Ji-long Hao ◽  
Xiu-fen Liu ◽  
Ling-ling Liang ◽  
Dan-dan Zhou
Keyword(s):  
Vision Loss ◽  
Hypodermic Needle ◽  
Ocular Infection ◽  
Ocular Injury ◽  
Antibiotic Administration ◽  
Hand Motion ◽  
Severe Vision Loss ◽  
The Right ◽  
Type Of Injury

Iatrogenic traumatic endophthalmitis is a rare but serious ocular infection that can lead to severe vision loss. A 44-year-old man presented with pain and decreased vision in the right eye 4 hours after injury with a hypodermic needle during irrigation of his eye. Slit-lamp examination revealed a penetrating corneal puncture and iris hole in the right eye. Twenty hours later, his visual acuity had decreased to hand motion, and severe fibrinoid uveitis was noted. He immediately underwent irrigation of the anterior chamber and intravitreal antibiotic injection. The right eye became painful again, and emergent vitrectomy combined with lensectomy was performed along with intravitreal antibiotic administration. The patient remained stable during the 2-month follow-up. Standard practice should be adopted when irrigating the eye to prevent this type of injury, and emergent surgical intervention is very important to preserve visual function.

Nutritional Support in the Patient with Traumatic and Nontraumatic Brain Injury

2017 ◽  
Author(s):  
Barbara Magnuson Woodward ◽  
Aaron M. Cook
Keyword(s):  
Health Care ◽  
Brain Injury ◽  
Energy Expenditure ◽  
Health Care Providers ◽  
Injured Patient ◽  
Nutrition Support ◽  
Nutrition Status ◽  
Care Providers ◽  
Optimal Outcomes ◽  
Cord Injury

The multiple metabolic alterations following neurologic injuries create several unique challenges for clinicians providing nutrition support. The hypermetabolic and hypercatabolic state following traumatic brain injury (TBI) has been well studied over the past three decades. This review discusses several unique issues to incorporate into the nutrition support plan for both acute traumatic and nontraumatic brain injuries. The initial energy expenditure assessment varies drastically among the different neurologic injuries, from the lowest with anoxic brain injury and spinal cord injury to the highest with traumatic subdural hemorrhagic injury. Measuring energy expenditure with indirect calorimetry becomes a critical component of the assessment due to wide-ranging metabolic needs and effects from various drug therapies. An excess or a lack of adequate nutrition support clearly results in worse neurologic and nutrition status outcomes. The nutrition status and preexisting comorbidities of the neurologically injured patient further compound the complexity of the nutrition plan. Anticipating and correcting for refeeding syndrome in the malnourished stroke patient or alcoholic hypermetabolic TBI patient avoid further metabolic, cardiac, and ventilator complications. Fluid balance must be continuously monitored and hyperglycemia avoided to prevent cerebral edema. Planning and implementing an aggressive nutrition support regimen inclusive of drug therapy, appropriate fluid status, electrolyte replacement, and close glucose monitoring incorporate the expertise of several health care disciplines to ensure optimal outcomes from the critical care setting. Nutrition support plans become one of the primary focuses during recovery following a neurologic injury. Proper swallow assessments and techniques to recognize dysphagia and avoid aspiration and its complications with pneumonia become paramount during the stroke rehabilitation phase. Due to the variety of acute neurologic injuries, health care providers must address each of the distinctive issues for an individualized nutrition support therapy to ensure optimal outcomes and minimize complications This review contains 1 figure, 4 tables, and 58 references.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

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