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Prehospital canthotomy: A sight-saving procedure in case series
Akmez Latona1,2,3,4, Nivene Saad5, Michael Hogden6
1LifeFlight Retrieval Medicine, Brisbane, Queensland, Australia.
Emergency Medicine Australasia : EMA
|April 16, 2022
Summary
Prehospital lateral canthotomy and cantholysis (LCC) for orbital compartment syndrome (OCS) is rare but crucial. Training and equipment are vital for prehospital physicians managing this time-sensitive condition.
Area of Science:
- Emergency Medicine
- Ophthalmology
- Trauma Surgery
Background:
- Orbital compartment syndrome (OCS) is a critical condition with rapid ischemic complications.
- Prehospital diagnosis and management of OCS present significant challenges due to environmental and logistical factors.
Purpose of the Study:
- To highlight learning points for performing lateral canthotomy and cantholysis (LCC) in the prehospital setting.
- To analyze the feasibility and outcomes of prehospital LCC in a specific aeromedical context.
Main Methods:
- Retrospective audit of lateral canthotomy and cantholysis (LCC) procedures.
- Data collected from January 2016 to December 2020 via electronic database retrieval.
- Keywords used: 'OCS' and 'LCC'.
Main Results:
- Three cases of prehospital LCC identified over a 5-year period from 7413 trauma missions.
- LCC was performed at the scene in two cases and at a rural hospital in one case.
- Discussion includes clinical, aeromedical, radiological findings, and visual outcomes.
Conclusions:
- Prehospital LCC for OCS is infrequent.
- Effective prehospital management requires appropriate equipment, comprehensive training, and standardized procedures for physicians.
- The Australian aeromedical context necessitates careful consideration for lengthy patient transfers.
