14 - Maxillofacial trauma: recognition, initial management and referral Flashcards
What makes up the pre-assessment of a trauma case?
- ATLS principles
- airways
- breathing
- circulation
- disability
ATLS
Advanced trauma life support
What are hard signs of mandible fracture?
- sublingual haematoma
- 2 point vertical mobility
- abnormal sensation or pain on contralateral side to injury
- numbness unexplained by direct injury to nerve
What does “red dot” indicate on radiographs?
Fracture detected
What is the treatment of suspected mandible fracture?
- fast patient
- analgesia
- antibiotic if open fracture
- liquid diet
- immediate contact with OMFS
What are hard signs of mid face fractures?
- nosebleed without blow to nose
- V2 numbness without blow to nerve
- subconjunctival bleed
- midface mobility
- malocclusion
- surgical emphysema around eye/swelling after blowing nose
- diplopia
- change of appearance
- CSF
Describe the appearance of CSF.
Water
What is epistaxis?
Nosebleed
How do you asses mid face mobility?
Fingers on palate and movement back and forth
What does swelling after blowing nose indicate?
Tear in sinus lining
Define diplopia.
Double vision
What is a le fort I fracture?
Fracture of maxilla from skull base
What is a le fort II fracture?
Fracture of nose down, not including orbit
What is a le fort III fracture?
Fracture including orbit and zygoma
What is the management for suspected fracture of zygoma?
- no indication for routine abx
- call OMFS, follow up likely 7-10 days
- no nose blowing
- soft diet
- warn re retrobulbar bleed
