Deep Dive MW R21

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 16 June 2024

⏱️ 13 minutes

🔗️ Recording | iTunes | RSS

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Summary

Orbital Compartment Syndrome – needs to be diagnosed CLINICALLY On exam, LOOK for: Proptosis, Ophthalmoplegia, Afferent Pupillary Defect, Vision Loss On exam, FEEL for: Rock hard globe, tense eyelids, resistance to retropulsion IOP > 40 means immediate canthotomy is indicated! Don’t perform if open globe is present Lateral Canthotomy Procedure: Anesthetize, Devascularize, Canthotomy, Cantholysis (inferior […]

Transcript

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0:00.0	Hello, residents. My name is Mike Estefan, and I thank you for joining me today on this
0:06.8	month's episode on the EM Clerkship podcast. On this month's episode, we are going to discuss
0:14.2	orbital compartment syndrome and the lateral canthotomy procedure. But before we begin,
0:23.7	just a quick word from our sponsor over at Pearson Rabbit's Insurance. Pearson Rabbit's is my personal disability insurance broker. They helped me
0:31.9	secure an own occupation disability insurance policy back in 2022 while I was still a resident, and I had a fantastic
0:40.4	experience working with their team. Obtaining own occupation disability insurance while young and
0:47.0	healthy is essential as a physician. You never know if or when tragedy will strike and you need to be prepared.
0:56.6	Pearson Rabbits specializes in helping physicians obtain specialty-specific own occupation disability insurance,
1:04.1	and you can trust them to protect your career.
1:08.6	Don't wait until it's too late.
1:13.6	Check out PearsonRavits at www. www.com and schedule a consultation appointment today. Don't forget to mention EM
1:20.0	Clarkship if you do. And now, back to the episode.
1:23.6	This episode is going to be short and sweet. We're going to talk about what orbital
1:29.9	compartment syndrome is. We're going to talk about how to recognize this clinically and how to
1:34.8	diagnose it. And then we're going to discuss the treatment for it, which is the procedure,
1:39.5	the lateral canthotomy. Orbital compartment syndrome is a vision-threatening emergency that occurs when the pressure
1:47.7	inside the orbit exceeds the pressure of the ophthalmic artery, and this leads to ischemia of the
1:55.2	retina and ischemia of the optic nerve. Now, 99% of the time for us in the ED, this is going to be caused by acute
2:03.5	facial trauma. The other times that it occurs are usually postoperatively or following excessive
2:10.4	fluid resuscitation, like, for example, in the setting of burn patients. Studies have shown
2:16.2	that permanent vision changes can begin to occur within an
2:20.4	hour of the initial injury, so it is extremely important to recognize this promptly.
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