EarHematomaDressing

One of the hardest bandages to apply well is one for auricular hematomas. After drainage, how would you apply a bandage to prevent the re-accumulation of blood in the perichondrial space?

Traditionally, one can wedge xeroform gauze or a moistened ribbon (used for I&D’s) in the antihelical fold. Behind the ear, insert several layers of gauze, which have been slit half way to allow for easier molding around the ear. Anterior to the ear, apply several layers of gauze to complete the “ear sandwich”. Finally, secure the sandwich in place with an ACE wrap, which ends up being quite challenging because of the shape of the head.

I’m just not sure how much direct pressure to the hematoma is applied using this technique, because the xeroform and ribbon gauze are so soft.

Trick of the Trade

Splinting the ear by using plaster

1. Create a plaster roll to appropriately fit the patient’s ear and soak it in water.
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2. Wrap with just one layer of padding so that the plaster does not stick to the patient’s ear.
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3. Wedge the ear splint firmly in place and apply gauze behind the ear.
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4. Apply several layers of gauze on top of the ear. Secure in place with a beanie hat (see prior Trick of the Trade).
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Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD