Ear, Nose and Throat

Emergencies

ED Nursing Residency Program

Franklin Square Hospital Center
 Basic Anatomy And Physiology
Malleus,
Incus, &
Stapes
Cochlea

External
Auditory
Canal
Tympanic
Membrane

Eustachian Tube
Assessment Questions???
 Environmental exposure
 Medications
 Onset of symptoms
 Associated symptoms
 Aggravating/alleviating factors
 Changes in hearing
 Drainage
 Hearing aids
 Method of cleaning ears
Foreign Body
 Be suspicious in the pediatric and mentally
challenged populations
 Symptoms
 Drainage

 Pain

 Hearing loss

 Swelling

 Redness

 Odor

 FB sensation
Foreign Body Removal
 Methods
 Suction
 Irrigation
 Alligator forceps
 Blunt angle hook
 Do not irrigate if the patient has a ruptured tympanic
membrane or vegetables in their ear.
 Use mineral oil, lidocaine or flash light for insects
 Medications
 Analgesics and antibiotics
 Patient education
 Do not put anything in the ear, avoid water in the ears
 Otitis Externa
 Symptoms: often from excessive accumulation or foreign
body obstruction
 Painful
 Itchy
 Diminished hearing
 Fullness
 Discharge
 Fever
 Deafness

 Interventions
 Ear wick
 Medication
 Cortisporin otic

 Hot compresses
 Avoid water in ears until infection clears
 Otitis Media
 Commonly associated with URI’s
 Symptoms
 Cough
 Postnasal drip
 Headache
 Pain
 Fullness
 Hearing impairment/loss
 Bulging tm
 Fever
 Pulling at ears (children)
 Not feeding (children)
Otitis Media
 Interventions
 Antibiotics
 Decongestants
 Pain medications

 Patient teaching
 Finish all antibiotics
 Follow-up for no improvement in 48 hrs
Ruptured Tympanic Membrane
 Symptoms  Traumatic
 Pain
 X-Rays
No intervention for small
 Discharge

ruptures
 Vertigo  Large ruptures may need
 Hearing loss
repair
 Fever/chills
 Bacterial
 Nausea/vomiting
 Antibiotics
 Recent injury

 Patient teaching
 Don’t blow your nose
 Keep ears dry
Meniere’s Disease
 Usually affects people  Treatment
between 40-50 years of  Medications
age  Valium
 Symptoms  Antivert
Anti-emetics
 Positional vertigo


 Dietary changes
 N/V
 Low sodium diet
 Sweats  Avoid caffeine
 Tinnitus  Nicotine
Chocolate
 Hearing loss


 Quiet environment
 Pressure/fullness
 Side rails up for safety
 Sensitive to noise
 Assess steadiness of gait
 Headache  Talk into good ear
 Blurred vision
Nasal Emergencies
Assessment Questions???
 Drainage
 Onset of symptoms
 Injury/trauma
 Environmental influences
 Medications
 Associated symptoms
 Allergies
 Nosebleeds
 Past medical history
Foreign Body
 Be suspicious in your pediatric and mentally challenged
population
 Symptoms
 Sinus pain
 Sore throat
 Ocular pain
 Toothache
 Nasal pain
 Edema of nares
 Discharge
 Unable to blow nose
 Odor
Foreign Body Removal
 Medications
 Decongestants And Anesthetics

 Methods
 Alligator Or Bayonet Forceps

 Suction

 Apply Pressure Over Opposite Nare And

Blow
Rhinitis
 Symptoms  Treatments
 Watery drainage  Medications

 Analgesics
 Sneezing
 Antipyretics
 Stuffiness
 Antibiotics
 Mucopurulent
 Antihistamines
drainage with
 Increase fluid intake
infection
 Humidifier
 Cough

 Sore throat

 Malaise
Epistaxis
 Anterior  Posterior
 Direct pressure  Assess ABC’S

 Epinephrine  Nasal packing

1:1,000 on a  Assess for volume

cotton ball with loss
direct pressure  Instruct pt not to
 Cautery blow nose and
sneeze with
mouth open
Nasal Fractures
 Symptoms
 Bleeding
 Bruising
 Swelling
 Sinus fractures may cause crepitus
 Treatment
 Assess ABC’S
 Control bleeding
 Ice
 Analgesics
 Patient education
 Avoid contact sports, exertion, blowing nose
Throat Emergencies
 Pharyngitis
 Peritonsillar abscess
 Foreign Body
Assessment Questions???
 Swallowing difficulties
 Sore throat
 Onset of symptoms
 Associated symptoms
 Past medical history
 Exposures
 Medications
 Foreign bodies
Pharyngitis
 Symptoms  Interventions
 Swollen tonsils  Throat culture
 Enlarged lymphs  Medications
 Sore throat  Antibiotics
 Dysphasia  Antipyretics
 Fever  Analgesics
 Ear pain  Increase fluid intake
 Odor  Warm saline rinses
 Magic mouthwash
 Monitor for sequelae
 Rheumatic fever
 Glomerulonephritis
Peritonsillar Abscess
 Symptoms
 Sore throat
 Dysphagia
 Fever/chills
 Pus/exudate
 Drooling
 Muffled voice
 Difficulty breathing
 Displaced uvula
 Position of comfort
 Treatment
 ABC’S
 I&D
 Antibiotics
Foreign Body
 Symptoms  Intervention
 Croupy cough  Heimlich maneuver

 Wheezing  Bronchoscopy

 Stridor  Esophagoscopy

 Choking  McGill forceps

 Unable to speak  Cricothyroidotomy

 Drooling  Soft tissue X-Ray

 Dysphagia

 Cyanosis

 LOC
 Reference
 Hoyt, K.S., & Selfridge-Thomas, J. (2007)
Emergency Nursing Core Curriculum (6th
ed.). St. Louis, Missouri: Saunders.