Canthotomy - Revision history

Ostermayer: /* See Also */

2024-10-17T14:53:52Z

Ostermayer: /* ProcedureBallard SR, Enzenauer RW, O'Donnell T, et al. Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage. J Spec Oper Med. 2009 Summer;9(3):26-32. */

2024-10-14T19:54:45Z

ProcedureBallard SR, Enzenauer RW, O'Donnell T, et al. Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage. J Spec Oper Med. 2009 Summer;9(3):26-32.

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	*Forceps		*Forceps

	==Procedure<ref name="JEM" /><ref name="CJEM" /><ref name="Spec Ops">Ballard SR, Enzenauer RW, O'Donnell T, et al. Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage. J Spec Oper Med. 2009 Summer;9(3):26-32.</ref>==		==Procedure==
	~~''Consider sedating patient for procedure, if time allows''~~		''Consider sedating patient for procedure, if time allows''<ref name="JEM" /><ref name="CJEM" /><ref name="Spec Ops">Ballard SR, Enzenauer RW, O'Donnell T, et al. Emergency lateral canthotomy and cantholysis: a simple procedure to preserve vision from sight threatening orbital hemorrhage. J Spec Oper Med. 2009 Summer;9(3):26-32.</ref>
	*Prep and drape the area (Irrigation with normal saline is acceptable prep given emergent nature of procedure)		*Prep and drape the area (Irrigation with normal saline is acceptable prep given emergent nature of procedure)
	*Inject lidocaine with epinephrine into the lateral canthus directing the needle tip toward the lateral orbital rim (away from the globe)		*Inject lidocaine with epinephrine into the lateral canthus directing the needle tip toward the lateral orbital rim (away from the globe)

Ostermayer: /* IndicationsMcInnes G, Howes DW. Lateral canthotomy and cantholysis: a simple, vision-saving procedure. CJEM. 2002 Jan;4(1):49-52. */

2024-10-14T19:54:26Z

IndicationsMcInnes G, Howes DW. Lateral canthotomy and cantholysis: a simple, vision-saving procedure. CJEM. 2002 Jan;4(1):49-52.

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	*Prolonged [[hypoxemia]]		*Prolonged [[hypoxemia]]

	==Indications<ref name="CJEM">McInnes G, Howes DW. Lateral canthotomy and cantholysis: a simple, vision-saving procedure. CJEM. 2002 Jan;4(1):49-52.</ref>==		==Indications==
	*Suspected acute orbital compartment syndrome (OCS), plus one or more of the following:		*Suspected acute orbital compartment syndrome (OCS), plus one or more of the following:<ref name="CJEM">McInnes G, Howes DW. Lateral canthotomy and cantholysis: a simple, vision-saving procedure. CJEM. 2002 Jan;4(1):49-52.</ref>
	**Decreased visual acuity		**Decreased visual acuity
	**IOP >40 '''or''' marked difference in globe compressibility by palpation		**IOP >40 '''or''' marked difference in globe compressibility by palpation

Ostermayer: /* CausesRowh AD, Ufberg JW, Chan TC, et al. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med. 2015 Mar;48(3):325-30. */

2024-10-14T19:54:05Z

CausesRowh AD, Ufberg JW, Chan TC, et al. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med. 2015 Mar;48(3):325-30.

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	*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>		*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>

	===Causes<ref name="JEM">Rowh AD, Ufberg JW, Chan TC, et al. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med. 2015 Mar;48(3):325-30.</ref>~~===~~		===Causes===
	*Trauma ([[retrobulbar hematoma]]) - most common cause		*Trauma ([[retrobulbar hematoma]]) - most common cause<ref name="JEM">Rowh AD, Ufberg JW, Chan TC, et al. Lateral canthotomy and cantholysis: emergency management of orbital compartment syndrome. J Emerg Med. 2015 Mar;48(3):325-30.</ref>
	*Spontaneous bleed		*Spontaneous bleed
	*Tumor		*Tumor

Rossdonaldson1: /* Contraindications */

2023-01-25T22:34:07Z

Contraindications

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	==Contraindications==		==Contraindications==
	*Globe ~~Rupture~~		*[[Globe rupture]]

	==Equipment==		==Equipment==

Rossdonaldson1: /* Background */

2023-01-18T21:45:35Z

Background

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	==Background==		==Background==
			[[File:Schematic diagram of the human eye en.png\|thumb\|Eye anatomy.]]
	*Acute [[Ocular compartment syndrome\|orbital compartment syndrome]] (OCS) is a clinical diagnosis		*Acute [[Ocular compartment syndrome\|orbital compartment syndrome]] (OCS) is a clinical diagnosis
	*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>		*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>

Blsimpso: /* Background */

2021-06-29T19:09:45Z

Background

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	==Background==		==Background==
	*Acute orbital compartment syndrome (OCS) is a clinical diagnosis		*Acute [[Ocular compartment syndrome\|orbital compartment syndrome]] (OCS) is a clinical diagnosis
	*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>		*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>

Hoxbox: /* External Links */

2021-04-11T11:20:13Z

External Links

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	==External Links==		==External Links==
	*EMRAP procedure video- https://www.youtube.com/watch?v=tgQaKVGynFA		*EMRAP procedure video- https://www.youtube.com/watch?v=tgQaKVGynFA
	*Review article: https://~~onlinelibrary.wiley~~.~~com/doi~~/10.1002/emp2.12372		*Review article by Murali et al: Orbital compartment syndrome: Pearls and pitfalls for the emergency physician. JACEP Open. 2021; 2:e12372. https://doi.org/10.1002/emp2.12372

	==References==		==References==

Hoxbox: /* External Links */

2021-04-11T11:18:56Z

External Links

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	==External Links==		==External Links==
	*EMRAP procedure video- https://www.youtube.com/watch?v=tgQaKVGynFA		*EMRAP procedure video- https://www.youtube.com/watch?v=tgQaKVGynFA
			*Review article: https://onlinelibrary.wiley.com/doi/10.1002/emp2.12372

	==References==		==References==

Rossdonaldson1: /* Background */

2021-03-17T17:48:05Z

Background

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	==Background==		==Background==
	~~[[File:Gray894.png\|thumb\|Anatomy.]]~~
	~~[[File:Gray379.png\|thumb\|Deeper anatomy.]]~~
	*Acute orbital compartment syndrome (OCS) is a clinical diagnosis		*Acute orbital compartment syndrome (OCS) is a clinical diagnosis
	*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>		*Vision loss can be permanent after 60-100 min of ischemia<ref name="JEM" /> - do not delay procedure for imaging<ref>Mohammadi F, Rashan A, Psaltis A, et al. Intraocular Pressure Changes in Emergent Surgical Decompression of Orbital Compartment Syndrome. JAMA Otolaryngol Head Neck Surg. 2015 Jun 1;141(6):562-5.</ref>

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	==See Also==		==See Also==
	*[[Orbital Hematoma]]		*[[Orbital Hematoma]]
			*[[Vertical lid split procedure]]

	==External Links==		==External Links==