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- problem if displaced, open,septal hematoma (major error if missed).
- if can breathe through both nostrils, not major deformity, then recheck in 4-5 days.
Analgesic, cold compress for hours, elevation of head. Warn signs of septal
high-dose Amoxil protocols
- 80-90 mg/kg/day
- 7 days for low-risk infants over age two, else 10 days
- failure at day 3: Rocephin, augmentin, clindamycin
persistent effusion (serous OM)
Assuming normal language, adequate hearing and behavior ...
- < 3 months: wait
- > 3 months: 10 day course Ab + "short" course of oral steroid
- > 6 months: tympanostomy
Prophylaxis is now out of favor. Preferred methods are treating with onset of URI
(selective prophylaxis) or with symptoms.
- Xylifresh Gum: chew frequently ($$)
- amoxil 20mg/kg qD if use
- parotid gland: upper buccal, across from top 2nd molars
- sublingual and submandibular: beneath tongue
- children: consider H. Flu, r/o epiglottitis (esp if not vaccinated)
- adults: viral, r/o angiodema (ACE inhibitors, familial). Sx therapy. No benefit with
Author: John G. Faughnan.
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