Archive for October, 2020

Construction Safety – Guardrail and Toe-board System

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House Innovative Safety Products, LLC.
A construction safety equipment company based in San Diego, California, we specialize in designing and manufacturing toe-board and guardrail systems to assure all of our customers the highest quality of construction safety equipment. H.I.S.P. supplies general contractors with safety equipment. H.I.S.P. products are manufactured in the United States and meet all OSHA safety standards 1926.502.
http://www.houseisp.com/
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Ear, Nose, and Throat – Otalgia (Ear Pain): By Russell Hollins M.D.

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medskl.com is a global, free open access medical education (FOAMEd) project covering the fundamentals of clinical medicine with animations, lectures and concise summaries. medskl.com is working with over 170 award-winning medical school professors to provide content in 200+ clinical presentations for use in the classroom and for physician CME.

Ear, Nose, and Throat – Otalgia (Ear Pain)
Whiteboard Animation Transcript
with Russell Hollins, MD
https://medskl.com/Module/Index/otalgia

Otalgia, or ear pain, is a complex diagnostic challenge due to the numerous local conditions that can trigger it, as well as the multitude of near and distant sites that can refer pain to the ear. The way I approach ear pain is to classify it as arising from the external ear, from the middle ear, or from distant sites causing referred pain.

Here are some common causes of pain under each heading that you should always consider:

Pain arising in the external ear can be due to an infection, such as otitis externa or herpes simplex/zoster infection. Trauma to the external ear from burns or frostbite can also cause external ear pain. Finally, keep in mind the possibility of a foreign body impaction (such as a Q-tip) or carcinoma of the external canal.

Middle ear pain is most commonly due to acute otitis media. Think of this in a patient with fever, ear pain, and a bulging tympanic membrane on otoscopic examination.

Mastoiditis can also cause ear middle ear pain. Consider this in a patient with fever, lethargy, and tenderness and redness behind the ear with possible drainage. These patients should be referred to an ENT service for assessment and immediate treatment to prevent complications.

Pain to the ear can also be referred from other structures in the head and neck. If no pathology is found on ear exam, complete a thorough head and neck exam to identify a source of the pain. Common causes of referred pain include TMJ disorders, dental pain, cervical pain, migraine, and trigeminal neuralgia.

Always complete a thorough history and examination of the ear and of the head and neck on a patient presenting with ear pain. Patients with pain not responding to medication or with complications of ear pathology should be referred to an ENT specialist for further investigation and management.
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