EMT Chapter 33

1. Slide 1

Advance Preparation

Review local protocols on the management and transportation of patients with eye, face, and neck injuries.

Bring anatomical models of the skull, eye, and ear to class. (See slide 8.)

2. Slide 2

The objectives for this chapter meet and exceed the National EMS Education Standards. Briefly introduce these objectives to your students so they get a feel for what’s ahead in the upcoming lesson and can anticipate the emphasis points of your presentation.

3. Slide 3

The objectives for this chapter meet and exceed the National EMS Education Standards. Briefly introduce these objectives to your students so they get a feel for what’s ahead in the upcoming lesson and can anticipate the emphasis points of your presentation.

4. Slide 4

The objectives for this chapter meet and exceed the National EMS Education Standards. Briefly introduce these objectives to your students so they get a feel for what’s ahead in the upcoming lesson and can anticipate the emphasis points of your presentation.

5. Slide 5

Planning Your Time

Plan 90 to 110 minutes for this chapter as follows:

Anatomy of the Eye, Face, and Neck (15 minutes)

Eye, Face, and Neck Injuries (15 minutes)

Specific Injuries Involving the Eye, Face, and Neck (60 minutes)

Note: The total teaching time recommended is only a guideline.

6. Slide 6

Case Study Discussion

The following case study is intended to challenge your students to think about how to assess and manage a patient with an eye injury.

Present the case in a way that your students will imagine being on the call and feel challenged by the circumstances of the incident. 

If appropriate, briefly relate a personal experience you’ve had running a similar call and how you managed it.

7. Slide 7

Case Study Discussion, continued

You and your partner are working on EMS Unit 201 today.

You’ve been dispatched to 400 Mill Street.

You have a 22-year-old male patient complaining of blindness and severe eye pain.

Time out is 1345 hours.

8. Slide 8

Case Study Discussion, continued

As you pull into the patient’s driveway, a neighbor greets you: “He’s in the house!”

Crossing the patient’s driveway, you see battery jumper cables linking two cars together.

Beneath the hood of one of the cars, you see powdery white battery acid sprayed across the engine.

Once inside the patient’s home, you hear someone screaming, “My eyes! My eyes! I can’t see!”

9. Slide 9

Case Study Discussion, continued

Are there any scene hazards that need to be addressed before approaching the patient?

Aside from the patient’s complaint of eye pain and blindness, are there other injuries you should anticipate?

10. Slide 10

Teaching Time

15 minutes

Teaching Tip

Use anatomical models to review the structures of the eye, face, and neck.

Class Activity

Have each student, without opening the book, draw and label the anatomy of the eye. Then have groups of students compare and compile their drawings and come up with a revised, labeled drawing to turn in for review.

11. Slide 11

Discussion Questions

What is the pupil of the eye?

What is the orbit of the eye?

12. Slide 12

Talking Points

The globe of the eye, or eyeball, is a sphere approximately one inch in diameter.

All of the structures of the eyes, the muscles that hold the eyes in position, and the orbits of the eyes are susceptible to trauma ranging from minor abrasion and irritation to impaled objects that invade the interior of the eye and extrusions in which an eye is pulled out of its socket.

Points to Emphasize

The sclera is the outer coat of the eye. The cornea is a clear cover over the colored iris; the opening in its center is the pupil.

The interior of the eye contains a smaller anterior chamber, and a larger vitreous body, which is filled with vitreous humor.

13. Slide 13

Points to Emphasize

The face consists of 13 fused bones and the moveable mandible, or lower jaw.

The bones of the face are part of the skull. An injury to the face can mean an injury to the brain.

Facial lacerations can bleed profusely. Blood, bone and tooth fragments, as well as other tissues can compromise the airway.

Discussion Question

What bones make up the face?

14. Slide 14

Talking Points

Collectively the skull is made up of 22 bones, eight of which form the cranium and 14 that comprise the facial bones.

Thirteen of these facial bones, the orbits of the eyes, the nasal bones, the zygomatic bones, and the maxillae are immovable. The mandible moves on hinged joints.

The face is extremely vascular and facial injuries, even minor ones, may bleed profusely.

Blood and pieces of broken bone, teeth, and other tissues may cause airway compromise when the face is injured.

Compromise of the facial structures can also cause a closed or an open brain injury with possible leakage of cerebrospinal fluid from the nose or ears.

A mechanism of injury that causes trauma to the face is likely to cause injury to the spine.

15. Slide 15

Discussion Question

What structures are contained within the neck?

Point to Emphasize

The neck contains numerous vital structures in a small space, including major blood vessels, the trachea and larynx, esophagus, spine, muscles, and endocrine tissue.

16. Slide 16

Talking Points

The neck contains numerous vital structures in a very small space.

Body systems represented within the neck include the cardiovascular, musculoskeletal, central nervous, respiratory, digestive, and endocrine systems.

More specifically, the neck contains the major (carotid) arteries and (jugular) veins that carry blood to and from the head.

It also contains major structures of the airway, including the trachea and the larynx.

Injuries to the neck can cause life-threatening bleeding and airway compromise that can be very difficult to control.

Damage to structures of the airway are serious life threats.

Assume that any injury to the neck has caused spine injury.

Critical Thinking Discussion

What would be the consequences of injury to the thyroid gland in the neck?

17. Slide 17

Teaching Time

15 minutes

18. Slide 18

Discussion Question

What are some causes of airway compromise in the patient with injuries to the eye, face, or neck?

Point to Emphasize

Assess the mechanism of injury leading to eye, face, and neck injuries.

19. Slide 19

Talking Points

Because mechanism of injury will guide your treatment, think about the forces behind the injury as soon as you get the dispatcher’s call.

Soft tissue injury to the face and neck is common in trauma.

Over half of the cases of facial trauma that present to the emergency department result from motor vehicle crashes, with assaults and sports-related injuries making up the majority of remaining cases.

During the scene size-up, gathering information from the patient may be difficult because he is likely to be in a state of extreme pain and emotionally distraught.

Try to determine the mechanism of injury or nature of the problem from bystanders, friends, or family.

Make sure to protect your own safety and call for police backup if the mechanism of injury involves an assault.

20. Slide 20

Points to Emphasize

Assess the airway, breathing, and circulation.

Consider the need for manual in-line spine stabilization.

Patients with chemical burns or impaled objects in the eye, an extruded eyeball, airway compromise, severe bleeding, respiratory distress, or severe injuries to the face and neck are high priority for immediate transport.

21. Slide 21

Talking Points

Severe trauma to the face and neck can cause an altered mental status, airway compromise, severe bleeding, and a spine injury.

Establish manual in-line stabilization of the head and neck.

Control major bleeding with direct pressure.

Open and maintain the airway. Suction if necessary.

Consider advanced life support backup

Provide oxygen, and ventilate the patient if necessary.

22. Slide 22

23. Slide 23

Talking Points

Conduct a secondary assessment.

Inspect and gently palpate for any sign of injury to the eye sockets or bones of the cheek, nose, or jaw.

If the patient has suffered an eye injury, use a small penlight to examine the eyes. Never push directly on the eyes.

Record the vital signs and, in patients with severe bleeding, be prepared to treat for shock.

Obtain a history. Make sure to ask the patient or bystanders questions regarding the events leading up to the injury.

Look for signs and symptoms of eye, face, and neck injuries and provide the appropriate emergency medical care.

Conduct a reassessment and check all interventions. Monitor especially for deterioration of mental status, airway, or breathing. Conduct the reassessment every five minutes if the patient is unstable or every 15 minutes if the patient is stable.

24. Slide 24

Teaching Time

60 minutes

25. Slide 25

Points to Emphasize

Symptoms of significant eye injury include loss of vision that does not improve with blinking, loss of part of the visual field, severe eye pain, double vision, and unusual sensitivity to light.

Do not force open the eyelids unless required to irrigate chemicals from the eye. Irrigate with water or saline for at least 20 minutes for chemical injuries.

Cover both the injured and uninjured eye, but do not apply pressure to an injured eye.

Discussion Question

What should you be looking for in the assessment of an injured eye?

26. Slide 26

Talking Points

During the physical exam, assess the eyes separately and together with a small penlight to evaluate the orbits, the lids, the conjunctivae, the globe, and the pupils.

Ask the patient to follow your finger as you evaluate the eye movements in all directions for abnormal gaze, paralysis of gaze, or pain on movement.

Regardless of the injury, remember the following basic rules when giving emergency medical care for eye injuries:

- If the eye is swollen shut, avoid any unnecessary manipulation.

- Do not try to force the eyelid open unless you have to wash out chemicals.

- Consult medical direction or local protocol before irrigating.

- Do not put salve or medicine in an injured eye.

- Do not remove blood or blood clots from the eye.

- Limit the patient’s use of the uninjured eye.

- Every patient with an eye injury must be transported.

- Never apply direct pressure to an injured eye.

27. Slide 27

Talking Points

Foreign objects-such as particles of dirt, sand, cinders, coal dust, or fine pieces of metal-can be blown or driven into the eye and lodged there.

A flow of tears often washes out these substances before any harm is done.

A patient with a foreign object in the eye will complain of feeling the object, and the globe will appear red.

Determine if the patient or others made any attempt to remove the object.

Generally, you should transport the patient for further medical evaluation rather than attempt to remove foreign particles from the eye in the field. Only attempt to remove objects in the conjunctiva, not those on the cornea or lodged in the globe.

Follow local protocols and medical direction when treating or removing an object in the conjunctiva.

If a foreign object becomes lodged in the eyeball, do not attempt to disturb it. Place a bandage over both eyes and transport the patient as soon as possible.

28. Slide 28

Talking Points

Trauma to the face may result in the fracture of one or several of the bones that form the orbits of the eyes. If you suspect a fracture of the orbits, establish and maintain spine stabilization.

The signs and symptoms of orbital fracture include the following: diplopia; a marked decrease in vision; loss of sensation above the eyebrow, over the cheek, or in the upper lip; nasal discharge; tenderness to palpation; a bony “step-off”; or paralysis of upward gaze in the involved eye.

Orbital fractures may require hospitalization and possible surgery.

If the signs and symptoms lead you to suspect a possible orbital fracture, take the following emergency medical care steps:

- If the eyeball has not been injured, place cold packs over the injured eye to reduce swelling and transport the patient in a sitting position.

- If you suspect injury to the eyeball, avoid using cold packs and transport the patient in a supine position.

29. Slide 29

Talking Points

Lid injuries include bruising (black eyes), burns, and lacerations.

Because the eyelid is richly supplied with blood vessels, lacerations can cause profuse bleeding. Anything that lacerates the lid can also cause damage to the eyeball, so assess the injury carefully.

To treat a lid injury:

- Control bleeding with light pressure from a dressing.

- Use no pressure at all if the eyeball itself may be injured.

- Cover the lid with sterile gauze soaked in saline to keep the wound from drying.

- Preserve any avulsed skin and transport it with the patient for possible grafting.

- If eyeball injury is not suspected, cover the injured lid with cold compresses to reduce swelling.

- Cover the uninjured eye with a bandage to decrease movement, and transport.

30. Slide 30

Talking Points

Injuries to the globe of the eye include bruising, lacerations, foreign objects, and abrasions.

Overuse of contact lenses can cause corneal abrasions, inflammation of the conjunctiva, and corneal ulcers.

Deep lacerations and penetrating injuries can cut the cornea, causing the contents of the eyeball to spill out.

Some injuries to the globe are immediately apparent. Other signs and symptoms of injury may include a pear-shaped or irregularly shaped eyeball and blood in the anterior chamber of the eye, a condition called hyphema.

Injuries to the globe are best treated at the hospital.

In the field, apply patches lightly to both eyes unless you suspect a ruptured eyeball. Avoid the use of cold packs over the globe, and if you apply an eye shield to the injured eye, be sure that it puts no pressure on the injury. Keep the patient supine, and transport.

31. Slide 31

Talking Points

A chemical burn to the eye represents a dire emergency and requires immediate treatment.

Burning and tissue damage can occur within seconds and will continue as long as any substance is left in the eye, even if that substance is diluted.

The signs and symptoms of chemical burns to the eye include a history consistent with exposure; irritated, swollen eyelids; redness of the eye or red streaks across the surface of the eye; blurred or diminished vision; excruciating pain in the eyes; or irritated, burned skin around the eyes.

In all chemical burns of the eye, begin irrigation with only water or saline for at least 20 minutes. You may have to force the lids open to wash behind them. If available at the site, use an eye wash system. Contact lenses must be removed or flushed out. If left in, they trap chemicals between the contact lens and the cornea. Remove any solid particles from the surface of the eye with a moistened cotton swab. Place the patient on his side on the stretcher and continue irrigation throughout transport.

Discussion Question

What is the care for an extruded eye?

32. Slide 32

Talking Points

Do not remove impaled or embedded objects in the eye.

Field care consists of stabilizing the object to prevent accidental movement or removal until the patient receives further medical attention.

During a serious injury, the eyeball may be forced or extruded out of the socket. Never attempt to replace the eye in the socket.

An impaled object in the eye or an extruded eyeball is a true emergency.

Emergency medical care is the same for both. Immobilize the head and spine. Encircle the eye and the impaled object or extruded eyeball with a gauze dressing. Place a metal shield, crushed paper cup, or cone over the impaled object or extruded eyeball. Hold the cup and dressing in place with a bandage that covers both eyes. Do not wrap the bandage over the cup. Make sure you bandage both eyes to prevent eye movement. Reassure the patient and transport immediately.

33. Slide 33

34. Slide 34

Talking Points

The presence of contact lenses often further complicates eye injuries.

To detect lenses, shine a penlight into each eye at a slight angle.

When determining whether to remove contact lenses, seek medical direction and follow local protocol.

Generally, remove contact lenses if there has been a chemical burn to the eye; the patient is unresponsive; the patient is wearing hard contact lenses; or transport time will be lengthy or delayed.

Generally, do not remove contact lenses if the eyeball is injured (other than a chemical burn) or the transport time will be short.

Soft and hard contact lenses can be removed in different ways.

Use a contact lens removal kit to remove hard contact lenses. The kit also contains a portable lens case that you can put each contact lens in for safe transporting to the hospital.

35. Slide 35

Discussion Question

What are the primary complications of facial injury?

Points to Emphasize

The mandible usually fractures in at least two places, creating instability.

Patients with severe facial trauma may require aggressive airway management, including finger sweeps, suction, manual maneuvers, and oral airways.

Critical Thinking Discussion

A patient received a glancing shotgun blast to the right side of the face, which was largely destroyed. He is alert and oriented although extremely distraught. He has a large amount of bleeding from the wounds but is able to manage his airway as long as he is sitting up. Given the mechanism of injury, you are aware that there is some risk of cervical spine injury. How will you balance airway management with concern over the cervical spine?

36. Slide 36

Talking Points

During your scene size-up, consider the mechanism of facial injury.

In any case of severe facial trauma, suspect cervical spine injury. Establish manual in-line stabilization of the spine on first contact with the patient and maintain it until the patient can be completely immobilized to a long backboard.

Immediately manage airway, breathing, and circulation problems. Be prepared to suction.

Severe trauma to the face may also cause an altered mental status.

Request advanced life support backup, if needed and available.

Provide oxygen and begin positive pressure ventilation if necessary.

Control severe bleeding. Apply pressure gently if you suspect fractured or shattered bones under the wound.

If nerves, tendons, or blood vessels have been exposed, cover them with a moist, sterile dressing.

Conduct a secondary assessment. Palpate for evidence of trauma.

Treat for shock and transport.

37. Slide 37

Talking Points

If a tooth has been lost, try to find it. To treat for an avulsed tooth:

Rinse the tooth with saline to gently remove any debris; never scrub the tooth. Transport the tooth in a cup of saline or wrapped in gauze soaked in sterile saline. Seek medical direction. Follow local protocol. Never wrap the tooth in dry gauze. Guard against the tooth drying out.

Never handle the tooth by the root; ligament fibers may still be attached that could enable successful reimplantation.

If you cannot find teeth that have been knocked out, assume that the patient has swallowed or aspirated them.

Control bleeding from the tooth socket with a gauze pad.

Point to Emphasize

Rinse debris away from an avulsed tooth with saline. Transport the tooth in a cup of saline or gauze soaked in saline.

Discussion Question

What are your concerns for a patient whose injury results in missing teeth?

38. Slide 38

Talking Points

Mid-face and jaw injuries may be simple, such as undisplaced nasal fractures, or extensive, involving severe lacerations, bony fractures, and nerve damage.

Signs and symptoms of fracture or other severe trauma to the mid-face, upper jaw, and lower jaw include:

- Distortion of facial features

- Crepitation or irregularities in the facial bones that can be felt

- Severe bruising and swelling; black eyes

- Bleeding from the nose and mouth

- Limited jaw motion or inability to open the mouth

- Painful or difficult speech

- Missing, loosened, or uneven teeth

If you note a significant mechanism of injury or any of the signs and symptoms just listed, treat as if a fracture has occurred. Your first priorities are establishing and maintaining spine stabilization and a patent airway, supporting breathing as necessary, and controlling life-threatening bleeding.

39. Slide 39

Talking Points

If the patient has a foreign object impaled in the cheek, stabilize it with bulky dressings and transport the patient.

If the object has penetrated all the way through the cheek and is obstructing the airway, remove it as follows:

- Pull or push the object out of the cheek in the opposite direction from which it entered the cheek.

- Pack dressing material between the patient’s teeth and the wound. Leave some of the dressing outside the mouth and tape it there to prevent the patient from swallowing the dressing. Monitor closely to make sure the dressing doesn’t become loose and compromise the airway.

- Dress and bandage the outside of the wound to control bleeding.

- Consider requesting ALS backup, as advanced airway procedures may be needed.

- Suction the mouth and throat frequently throughout transport.

40. Slide 40

Talking Points

Assess and care for soft tissue injuries to the nose as you would other soft tissue injuries.

Take special care to maintain an open airway, and position the patient so that blood does not drain into the oropharynx or pharynx.

Nasal fractures are the most common type of facial fracture. If fractures occur to the underlying nasal bones and deeper nasal structures, significant hemorrhaging and airway obstruction may occur.

Never pack the injured nose. Attempt to control the bleeding, apply a cold compresses to reduce swelling, and transport.

Do not try to remove a foreign object in the nose.

Points to Emphasize

Position the patient with a nose injury so that blood does not enter the airway.

Do not try to remove a foreign object inserted into the nose or ear.

41. Slide 41

Talking Points

Cuts and lacerations of the ear are common. Occasionally, a section of the ear may be severed.

The pinna is frequently traumatized with injuries to the head. Because of the limited blood supply, it fortunately does not bleed significantly when injured.

Assess and treat as for other soft tissue injuries.

Save any avulsed parts; wrap avulsed parts in saline-soaked gauze, and transport with the patient.

When dressing an injured ear, place part of the dressing between the ear and the side of the head. Never pack the ear to stop bleeding from the ear canal. Place a loose, clean dressing across the opening of the ear to absorb blood and fluids, but do not exert pressure to stop the bleeding.

Do not attempt to remove a foreign object in the external ear.

42. Slide 42

Points to Emphasize

In addition to life threatening hemorrhage, lacerations of the major blood vessels in the neck can put the patient at risk for an air embolism.

Subcutaneous emphysema in the neck is an indication of an injury to airway structures.

Discussion Questions

What is subcutaneous emphysema? How does it occur?

How can air embolism occur in the patient with an injury to a jugular vein?

43. Slide 43

Talking Points

The neck can be injured by any blunt or penetrating trauma.

Signs and symptoms of an injured neck include lacerations; swelling or bruising; difficulty speaking; a change in voice; subcutaneous emphysema; crepitation; and displacement of the trachea.

To treat a neck injury, use proper Standard Precautions; establish and maintain in-line spine stabilization; establish a patent airway; provide high-flow, high-concentration oxygen and positive pressure ventilation as necessary; control severe bleeding; treat for shock; and transport.

Jugular vein lacerations require the application of an occlusive dressing.

Class Activity

To assess students’ ability to integrate the knowledge in this section, have groups of students write five to ten questions they predict will be on an exam covering this material. Have each group quiz the rest of the class.

Knowledge Application

Given a series of scenarios, students should be able to assess and manage a variety of patients with injuries of the eye, face, and neck.

44. Slide 44

Case Study Follow-Up Discussion

This case study is continued from the beginning of the presentation.

Briefly remind students that they are dispatched for a 22-year-old male patient complaining of blindness and severe eye pain.

As you approach the patient’s driveway, you see no safety hazards.

Walking past two vehicles with jumper cables, you begin to think the mechanism of injury might be an exploding car battery.

The sight of white battery acid sprayed across the car hood and a brief talk with a neighbor confirm your suspicion. The neighbor tells you the patient was smoking a cigarette over the car battery when there was a big explosion.

45. Slide 45

Case Study Follow-Up Discussion, continued

Once inside the patient’s house, you find him running around the living room with a wet towel wrapped around his face.

He tells you his name is Hector Fernandez. He says he can’t see, and it hurts “really bad.”

Since he is talking to you and answers questions appropriately, you determine that Hector’s airway, breathing, and mental status are adequate.

He denies breathing difficulty but tells you both eyes are extremely painful.

Your general impression is that Hector seems alert and oriented, but he needs eye care immediately or he’ll be in danger of losing his sight.

Quickly you walk the patient into the kitchen.

You ask if he is wearing contact lenses. He says “no.”

You direct the patient to lean over the sink.

Next you turn on the faucet and direct Hector to lean under it. You have him turn his head from side to side so that the water runs from the medial to the lateral side of each eye in turn.

46. Slide 46

Case Study Follow-Up Discussion, continued

You are unable to conduct an exam of Hector’s eyes while he is irrigating them at the kitchen sink.

Your partner is able to take Hector’s baseline vitals. He reports Hector’s pulse at 120 bpm; his blood pressure is 140/80 mmHg. His skin is warm and dry. His respirations are regular at 24 per minute.

Meanwhile, you are able to gather a history from Hector who replies to your questions while continuing to keep his eyes under the running water.

He describes the pain in his eyes as “about seven or eight” on a scale of one to ten.

He reports no known allergies and is not taking any medications.

His last oral intake was lunch about an hour ago.

Events leading to the present problem were, as described by the neighbor, an explosion of battery acid while he was working on his car. You note no other signs of trauma.

Medical direction instructs you to irrigate for a total of 20 minutes prior to transport and continue to irrigate en route.

47. Slide 47

Case Study Follow-Up Discussion, continued

While you are busy treating Hector’s eyes, your partner conducts a secondary assessment to look for further injuries from the battery explosion.

He does not find any further trauma.

After 20 minutes of irrigation with copious amount of tap water from the sink, Hector’s pain decreases.

He says, “I can see, now-some.”

You place Hector on his side on the stretcher with a basin under his head.

You continue irrigation with your ambulance’s bottled water and transport.

48. Slide 48

Case Study Follow-Up Discussion, continued

You perform a reassessment.

Hector’s vital signs are stable, and you reassess his eyesight to find that it continues to improve.

Once at the hospital, you transfer Hector to the care of emergency department personnel.

You provide an oral report, complete your prehospital care report, and prepare the ambulance for return to service.

Case Study Follow-Up Discussion Questions

Why was plain water from the kitchen tap the best choice for irrigating Hector’s eyes?

How could Hector’s injury have been prevented?

49. Slide 49

Critical Thinking Discussion

This critical thinking scenario is intended to challenge your students to think about managing a patient with facial trauma and a potentially unstable airway.

The scenario continues on the next slide.

50. Slide 50

Critical Thinking Discussion, continued

The scenario continues on the next slide.

51. Slide 51

Critical Thinking Discussion, continued

The scenario continues on the next slide.

52. Slide 52

Critical Thinking Discussion, continued

Ask students to briefly discuss the scenario before moving on to the series of questions on the next slide.

53. Slide 53

Critical Thinking Discussion, continued


Establish and maintain manual in-line spine stabilization while opening the airway with a jaw-thrust maneuver. The other EMT should immediately suction the airway clear of blood, secretions, and any other substances. Begin bag-valve-mask ventilation if necessary and provide high-flow, high-concentration oxygen.

This patient may be unresponsive for numerous reasons including a traumatic brain injury, hypoperfusion, hypoxia due to an occluded airway, or even alcohol or drug overdose.

54. Slide 54

Critical Thinking Discussion, continued


If suctioning fails to adequately clear this patient’s airway, consider placing the patient in a lateral recumbent position while maintaining spine stabilization to allow the blood to drain from the patient’s oropharynx. If the patient is already immobilized on the backboard, it would be appropriate to turn the entire backboard on its side. Continue to suction.

Encircle the extruded eye with a gauze dressing and, without applying any pressure to the injury, cover it with a metal shield, crushed paper cup, or cone. Then gently secure the cover or cup to the patient’s face with roller gauze while also covering the uninjured eye.

The probability is very high that this patient will need advanced airway management due to the massive facial trauma and bleeding into the airway. An endotracheal tube will isolate the trachea and prevent any blood from leaking down the trachea, past the inflated cuff, and into the lungs.

55. Slide 55

Please visit www.bradybooks.com and follow the MyBradyKit links to access content for this text. Under instructor resources, you will find curriculum information, lessons plans, PowerPoint slides, TestGen, and an electronic version of the instructor’s edition. Under student resources, you will find quizzes, critical thinking scenarios, weblinks, animations, and videos related to this chapter-and much more.