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Bryan I. Fagan

丁香诊所 急诊科

急诊科视频 / 时长34分钟

丁香诊所全科培训课程 16:眼内异物的处理方法

¥12.00

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课程介绍

处理眼内异物,在所有操作之前,最重要的是先检查双眼视力,并准备好破伤风疫苗。角膜损伤或异物的症状包括异物感,流泪和充血,视力通常不会发生改变。采集病史时,需要询问患者是否佩戴隐形眼镜,然后确定是何种异物或化学药品进入眼内。如果检查发现荧光素从角膜缺损处流出,或瞳孔呈泪滴状,或者涉及到高速机器,锤击或爆炸,都有怀疑存在眼内异物。

对于化学药品入眼,第一步应急处理是让患者平躺,局麻后立即用大量清水或 Lactated Ringer 液冲洗至少 15 分钟。再用荧光素染色检查眼睛看是否存在角膜破溃,并检查 pH。很多化学损伤是由酸引起的,由于酸损伤仅发生在角膜浅层,所以通常其预后良好;而碱烧伤虽然不常见,却更严重。二者均需及时看眼科医生。去除眼睑异物时,先外翻眼睑,再将异物冲洗掉或用湿棉签擦拭掉,并检查是否存在角膜磨损。

对于角膜异物,局麻后采用冲洗、湿棉签或者针头的方法去除。在怀疑存在渗漏(如前房积血、积脓),角膜溃疡,视力下降,去除金属异物后存在锈迹等情况下需及时到眼科就诊。需要牢记的几点是按时复诊检查视力、注射破伤风疫苗和局部应用抗生素。

在丁香诊所「全科医生强化培训班」中,来自马里兰大学医学院附属医院急诊科医生助理 Bryan Faganl 与大家一起讨论《眼内异物》。

更多精彩内容请点击此处观看丁香公开课全部课程。

封面图片来源:shutterstock 网站

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Bryan I. Fagan 丁香诊所 急诊科

Bryan I. Fagan,马里兰大学医学院附属医院急诊科医生助理(PA)、PA学校带教老师。

EDUCATION:
2002-2004 Bachelor of Science, University of Nebraska, College of Medicine-Interservice Physician Assistant Program (U.S. Army)
1996-1997 Associate of Science, George Washington University, Health Laboratory Sciences

EMPLOYMENT:
2013-present: Physician Assistant/US Army Maryland National Guard officer (65D) Care and treatment of military personnel.
2010-present: Physician Assistant, Bel Air Center for Plastic and Hand Surgery/Ramon A. de Jesus, MD, LLC; evaluation and treatment of patients with upper extremity problems/trauma and plastic/reconstructive needs.
2004-present: Physician Assistant, Dept. of Emergency Medicine, Upper Chesapeake Health System- under the direction of the attending physician, assessment and treatment of acute illnesses and injuries in the urgent care and main emergency department. I have been the Lead PA/Director of MLPs since 2012.
1995-2006: US Army Reserve, (Honorable Discharge 02/16/2006) Team member in US Army Medical Department NCO and Commisioned Officer
1998-2004: Medical Laboratory Technician, Johns Hopkins Hospital processing and evaluation of routine and STAT clinical medical specimens in microbiology, virology, hematology, immunology, and clinical chemistry.

CERTIFICATIONS and LICENSES:
Physician Assistant-Certified, NCCPA (recertified 11/2010)
Maryland State License
Maryland CDS
National DEA
BLS
ACLS
PALS
ATLS trained

MEMBERSHIPS:
American Academy of Physician Assistants

COMMITTEES:
Allied Health Review Committee
Meditech (hospital interface) introduction team Forerun and Dragon (voice -recognition EMR) introduction team
Clinical preceptor to PA students from Towson/CCBC and Anne Arundel Community College PA programs
Department peer review team
High Risk Patient management team
Emergency Department leadership
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