WFR Eye, Ear, Nose, and Dental Emergencies — Questions and Answers
Question 1: A glacier traveler who did not wear sunglasses has severe eye pain, a gritty feeling, and tearing about 8 hours after exposure. What is the likely diagnosis?
- Acute glaucoma
- Snow blindness (UV photokeratitis) (Correct answer)
- Conjunctivitis
- Retinal detachment
Correct answer: Snow blindness (UV photokeratitis)
Photokeratitis is a sunburn of the cornea caused by UV light, and symptoms appear several hours after exposure. Treat with cool compresses, darkness or eye patching, and pain relief. It usually heals within 24 to 72 hours.
Question 2: A stick is impaled in a patient's eye. What is the correct field management?
- Remove it carefully and irrigate
- Stabilize the object, protect the eye with a cup, cover both eyes, and evacuate (Correct answer)
- Apply firm pressure to the eye
- Flush with alcohol
Correct answer: Stabilize the object, protect the eye with a cup, cover both eyes, and evacuate
Never remove an object impaled in the eye. Stabilize it, shield the eye without putting pressure on it, and cover both eyes to reduce eye movement, because the eyes move together. Then evacuate.
Question 3: What is the best initial treatment for an anterior nosebleed?
- Tilt the head back and pinch the bridge of the nose
- Sit up, lean forward, and pinch the soft part of the nose firmly for 10–15 minutes (Correct answer)
- Lie flat and pack the nose with cotton
- Blow the nose forcefully
Correct answer: Sit up, lean forward, and pinch the soft part of the nose firmly for 10–15 minutes
Leaning forward stops blood from running down the throat. Steady pressure on the soft, compressible part of the nose controls most anterior nosebleeds.
Question 4: A permanent tooth is completely knocked out. What gives it the best chance of being saved?
- Scrub the root clean and wrap it in dry gauze
- Hold it by the crown, rinse briefly, and reimplant it, or store it in milk or saline (Correct answer)
- Throw it away, because permanent teeth can't be saved
- Store it in water for a week
Correct answer: Hold it by the crown, rinse briefly, and reimplant it, or store it in milk or saline
The root ligament cells need to stay alive. Handle the tooth only by the crown, don't scrub it, and reimplant it immediately if possible. Otherwise, keep it moist in milk, saline, or the patient's cheek. Success drops sharply after 30 to 60 minutes.
Question 5: A patient has a toothache with facial swelling spreading toward the eye, fever, and trouble swallowing. What is the right decision?
- Pain relievers and continue the trip
- Urgent evacuation for a spreading dental infection (Correct answer)
- Apply heat and wait
- Lance the swelling in the field
Correct answer: Urgent evacuation for a spreading dental infection
Spreading facial swelling, fever, and trouble swallowing show the abscess is spreading. It can threaten the airway or reach the brain, so the patient needs antibiotics and urgent evacuation.
Question 6: A patient has a small foreign body on the surface of the eye. What should the WFR try first?
- Remove it with tweezers
- Flush the eye gently with clean water from the inner corner outward (Correct answer)
- Rub the eye
- Apply antibiotic ointment and patch without looking
Correct answer: Flush the eye gently with clean water from the inner corner outward
Gentle irrigation from the inner corner outward is the safest first step. It washes debris away from the other eye and doesn't scratch the cornea. Lifting the eyelid or using a moist swab are the next options.
