Provision of emergency medical care for ENT diseases

Stop of nasal bleeding

Most often, nosebleeds are located in the anterior part of the nasal septum. With a slight bleeding, a simple and effective way to stop bleeding is to press the finger of the nose wing against the nasal septum. If this proves to be insufficient, a ball of sterile cotton wool or gauze moistened in a solution of hydrogen peroxide is injected into the anterior part of the nasal cavity. This ball needs to be pressed through the wing of the nose to the nasal septum for 10-15 minutes. If the bleeding is intense and the first method does not have the desired effect, the anterior tamponade of the nasal cavity is performed. Anterior tamponade is performed with the help of cranked tweezers, nasal forceps or Hartmann forceps. With bleeding from the forelegs of the nose, you can restrict the introduction of a tampon only to the front sections. With bleeding from the middle and back of the nose and the inability of the front tamponade, a tamponade of the entire nasal cavity should be performed. Long gauze tampons with a width of 1 - 1.5 cm consistently fill all the cavities of the nasal cavity: the posterior parts of the nasal cavity, the lower and middle nasal passages and the common nasal passage. The disadvantages of this method of stopping bleeding include possible damage to the mucous membrane and the withdrawal of the formed thrombi when removing the tampon even with the utmost caution. To avoid such consequences, it is recommended to wet tampons with hydrogen peroxide solution, thrombin solution or sterile vaseline oil.

Removal of foreign bodies from the nasal cavity of

Foreign bodies in the nasal cavity are found most often in children, who stuff themselves and their peers into their noses with various objects. This is most often beads, peas, cherries, seeds, buttons, pieces of paper, etc. Before removing the foreign body, it is necessary to carefully lubricate the nasal mucosa with vasoconstrictor and anesthetic solutions and determine the location of the foreign body by inspection and careful probing. A dull hook is held behind a foreign body under the control of vision, and then, turning the hook, a foreign body is pushed out by the movement "upon oneself".Flat or long and thin foreign bodies( pieces of paper, gauze, matches, nails) can be removed with nasal forceps or cranked tweezers. It is impractical and even dangerous to remove foreign bodies of rounded form using various forceps and tweezers, since these bodies slip out of them and are often pushed further.

Removal of foreign bodies from the pharynx

Foreign bodies usually get into the pharynx together with food( for example, bones, pieces of wood, grain of cereals, etc.).In the throat, fragments of dentures, objects held in the teeth( for example, coins, small toys, buttons, nails, pins) get stuck. Signs of foreign body pharynx - stitching in the throat, worse when swallowing, difficult swallowing, with large foreign bodies - shortness of breath. Removal of foreign bodies from the pharynx is not particularly difficult. From the area of ​​the middle part of the pharynx, tonsils and archs, sharp foreign piercing bodies can be removed with simple anatomical or elbow tweezers, but it is better to use nasal forceps with densely contiguous brushes. It must be remembered that scratches and abrasions left after a foreign body, sometimes simulate its presence and for a long time disturb patients.

Removing foreign bodies from the external auditory canal

Foreign bodies of the external auditory canal are very common. Children during the game enter into the ear a variety of subjects: sunflower seeds, peas, buttons, beads, small wooden objects, cherry stones, etc. In addition, various insects can enter the ear canal. The foreign body remains lying in the membranous part of the auditory canal and very often does not give any reaction, even with prolonged stay. Foreign bodies with sharp edges or prone to swelling cause painful sensations due to pressure on the walls of the ear canal and the tympanic membrane. Live foreign bodies give a feeling of great noise and tickling. Before you remove a living insect, you should drip alcohol or oil in your ear to kill it. The most safe and in most cases sufficient method for removing foreign bodies is to rinse the ear with warm water with a syringe( a detailed procedure mechanism is described in the section "Washing the sulfur plug").If by means of washing it was not possible to remove the foreign body, tools are used. This includes various hooks, spoons, corncangs and tweezers. It is necessary to caution against the use of tweezers for solid foreign bodies, since when they clamp their legs, the foreign body slips easily and is pushed even deeper into the ear canal. The safest tool is a small hook, which under the control of vision is held for a foreign body, after which the movement "on itself" is extracted together with a foreign body.

Acute lining of the laryngitis( false groats)

Most of the patients with acute lumbar lining are children up to 5-8 years old. The first signs of the disease are fever and cough. The general condition of the child during the day is quite satisfactory. At night, suddenly, an attack of suffocation begins, the child gasps for air, breathes noisily, turns blue. Appears barking cough, sometimes with vomiting and secretion of viscous sputum. The attack lasts from a few minutes to half an hour, after which the child falls asleep.

Treatment. The attack can be suppressed, causing a vomiting reflex by touching the spatula to the back of the pharynx or causing sneezing in the nose. The room in which the child is located should be well ventilated. To humidify the air, it is recommended to hang wet sheets in the room and boil the water in a saucepan. It is useful to drink warm( milk, Borjomi).Appoint also warm foot baths, mustards for calves. If the phenomena of suffocation are threatening, intubation or tracheostomy is used.

Acute phlegmonous-membranous( stenosing) laryngotraheronritis

Characteristic for children under 7 years. The onset of the disease is acute, with a rapid progression of the process. In untimely treatment, fibrinous films formed in the airway lumen cause asphyxiation, but death can occur earlier from severe intoxication with severe lesions of the internal organs and brain edema.

Treatment of .It consists primarily in intubation( extended nasotracheal intubation) or tracheostomy with immediate aspiration of mucus or films, artificial ventilation of the lungs, oxygenation. Prescribe broad-spectrum antibiotics in large doses, corticosteroids. Inhalations, proteolytic enzymes, etc. are also shown. If necessary, drugs stimulating the activity of the heart are recommended.

Acute stenosis of the larynx

Acute stenosis of the larynx is a constriction of the laryngeal lumen that sets in for a short time. These conditions threaten death from asphyxiation, so medical care must be provided immediately. With some acute stenoses, asphyxiation develops with lightning speed, for example, when a large foreign body enters the larynx. In other cases( sublingual laryngitis, edema, etc.), suffocation is acute, and finally, with traumas, tumors, chronic infections, gradual development of suffocation is possible.

Treatment. In any pathological state of the larynx, dangerous for the development of stenosis, urgent hospitalization and measures to prevent asphyxia are indicated. These include: restoration of laryngeal clearance( removal of foreign bodies, decongestants, intubation if necessary), elimination of hypoxia( inhalation of oxygen together with carbon dioxide for stimulation of the respiratory center);distracting, soothing and cardiovascular drugs. In the absence of effect from the listed measures, tracheostomy is produced.