Maxillofacial Trauma and Emergency Care

Maxillofacial Trauma

• The goal of treatment is to save the patient's life.
• First aid treatment focuses on airway management, breathing, circulation, pain control, and infection prevention.
• Causes of airway obstruction include a falling back of the tongue in unconscious patients, blood clots in the mouth, broken teeth, foreign bodies, and stomach contents.
• Positioning the patient, clearing the mouth, pulling the tongue, pushing the palate upward, and chin lifts can all help maintain a patent airway.
• Shock position involves raising the legs and head.
• Surgical airway (tracheostomy) is necessary in severe cases of airway obstruction.

Breathing and Adequate Ventilation

• Breathing confirmation is through look, listen, and feel.
• Supplemental oxygen is provided if breathing is shallow and rapid.
• Mouth-to-mouth breathing, face masks, ambu bags, and ventilators are methods to ensure adequate ventilation.

Circulation and Shock Management

• Hemorrhage (external and internal) can lead to hypovolemic shock.
• Hemorrhage in head and neck areas can originate from arteries (carotid, facial, superficial temporal, lingual).
• Soft tissue lacerations are a source of bleeding.
• Blood pressure levels are monitored continuously.

Control of Bleeding

• Soft tissue lacerations require suturing.
• Significant bleeding involves clamping major blood vessels.
• Nasal packing (with saline) is used for epistaxis.
• Blood pressure, 140 mm Hg systolic, BP 100–140 mm Hg=30% blood loss, systolic less than 100=more than 30% and needs transfusion.

Drugs for Control Pain and Infection

• Analgesics are used for pain relief.
• Suitable antibiotics prevent/treat infection.
• Tetanus antitoxin is given to non-immunized patients.

Surgical Airway

• Tracheostomy is a surgical procedure to establish an airway.
• Cricothyroidotomy is an emergency surgical procedure.

Cervical Spine Control

• Ensuring a stable cervical spine is crucial to prevent neurological damage (e.g., quadriplegia).
• Head immobilizers and sandbags are used to stabilize the cervical spine.

Facial Fractures (Le Fort Fractures)

• Le Fort 1, 2, and 3 fractures involve varying degrees of maxillary and facial bone displacement.
• Le Fort 3 is considered the most dangerous, involving craniofacial disjunction from the cranium.

Mandibular Fractures

• These involve the mandible bone.
• Etiologies of mid-face fractures include falls, road traffic accidents, industrial accidents, and sports-related injuries.
• Fractures can be classified by their location (anterior, parasymphseal, condylar).
• Displacement and the condition of the teeth are included in the classification and prognosis.

Soft Tissue Injuries

• Contusion involves blunt object trauma.
• Abrasion is superficial skin injury.
• Laceration is a deep wound of skin or tissue.
• Avulsion involves tearing away of soft tissue.
• Punctures are stab-like injuries (e.g., knife, gunshot, or a foreign object), requiring careful examination of the wound to confirm there's no missile/metal fragments.

Disability and Neurologic Assessment

• Glasgow Coma Scale assesses level of consciousness after a traumatic brain injury.
• AVPU (Alert, Verbal, Pain, Unresponsive) is a method for assessing consciousness.
• Vital signs are also checked (e.g., heart rate, blood pressure, respiratory rate, oxygen saturation).

This quiz covers the key concepts in managing maxillofacial trauma, focusing on airway management, breathing confirmation, and circulation in emergency situations. Participants will learn about first aid treatments, including techniques to maintain a patent airway and ensure adequate ventilation and circulation. Test your knowledge on the critical lifesaving measures required in trauma cases.