The case A 15-year-old female presents to the emergency department with her father following an unusual gardening accident. The patient was helping her father with lawn work and was using a weed whacker to trim the area around a chain link fence separating their property from the neighbor's. A small barb of fence wire was whacked directly into her right eye. She complained of decreased visual acuity and pain in the right eye. There was no loss of consciousness, and she sustained no other injuries. While the lesion was outwardly apparent, nonetheless, a computed tomography scan of the eye was obtained, confirming the presence of a foreign body in the right eye. The ophthalmology service has determined that timely surgical repair of the open globe injury is warranted. The patient ate a cheeseburger and fries for lunch approximately 3 hours ago. The patient has no past medical history. She had an appendectomy at age 8 under general anesthesia, without complications. She has no known drug allergies and is not on any medications. Physical examination reveals the following: temperature, 37°C heart rate, 105 beats per minute blood pressure, 118/78 respiratory rate, 20 pulse oximetry, 100% on room air anxious, alert, and oriented to person, place, and time Mallampati2, with full range of motion at the neck and with a thyromental distance greater than 6 cm cardiac is S1, S2, regular rate and rhythm, with no murmurs lungs are clear to auscultation bilaterally abdomen is soft, nontender, and not distended extremities are warm and well perfused The ophthalmologists are concerned about the possibility of vision loss.
|Original language||English (US)|
|Title of host publication||Core Clinical Competencies in Anesthesiology: A Case-Based Approach|
|Publisher||Cambridge University Press|
|Number of pages||6|
|ISBN (Print)||9780511730092, 9780521144131|
|State||Published - Jan 1 2010|
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