Airway Related

Question 1

Submental intubation vs Naso n orotracheal n tracheostomy….?

Answer 1

Nasal endotracheal intubation is contraindicated in–

midface fractures especially those involving cribriform plate

in fractures of base of Skull

comminuted midfacial fractures

Nasotracheal intubation can interfere with surgical reconstruction of # NOE….
Reconstruction often involves maxillomandibular fixation in the intra-operative period to restore patients dental occlusion this precludes the use of ORAL endotracheal intubation… in such cases tracheostomy may be indicated but it carries significant morbidity therefore in this case SUBMENTAL intubation is ideal….

Question 2

Gunshot wounds should be treated as?

Answer 2

As a rule grossly comminuted fracture is best treated by closed reduction because using open reduction jeopardize the blood supply to the small bone fragments and lead to an infection especially
Gunshot injuries belong to this type n should be treated as a bag of bones and managed by closed reduction because often in this case the bone is comminuted and there is a greater risk of infection in this fractures…