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학습 자료 둘러보기 →| Assessment Finding | Clinical Interpretation | Priority Level |
|---|---|---|
| Clear fluid drainage from the ear canal | This is the pathognomonic sign of a CSF leak (otorrhea), indicating a dural tear and communication with the subarachnoid space. It places the client at high risk for post-traumatic meningitis (PTM) [2,4]. | Highest Priority |
| Client reporting tinnitus in the affected ear | Tinnitus is a common symptom following acoustic trauma or injury to the inner ear structures. While distressing, it is not a specific indicator of a life-threatening skull base fracture in isolation [2]. | Non-urgent |
| Mild swelling of the external ear | This finding is consistent with soft tissue contusion from direct blunt force. It is an expected finding and does not signify intracranial injury. | Non-urgent |
| Presence of cerumen in the ear canal | Cerumen (earwax) is a normal physiological finding and is unrelated to acute traumatic pathology. | Non-urgent |
Following blunt head trauma, clear fluid drainage from the ear is the priority finding. This indicates cerebrospinal fluid (CSF) otorrhea secondary to a likely basilar skull fracture involving the temporal bone.
Do not pack or suction the ear canal. Instead, apply a loose, sterile gauze pad to absorb drainage and observe for the halo sign. The patient should be placed on bed rest with the head of the bed elevated 30 degrees.
A CSF leak creates a direct pathway for bacteria, placing the patient at high risk for meningitis. Instruct the patient to avoid coughing, sneezing, or blowing the nose to prevent pneumocephalus.
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