EAC maxilla-Facial and Eye Injuries

Question 1

Define:

Maxilla-Facial Injury

Answer 1

any physical trauma to the face

Question 2

mechanics of injury that may result in:

Maxilla-Facial Injury

Answer 2

RTC
Fights/Assaults
Falls

Question 3

special problems associated with:

Maxilla-Facial Injury

Answer 3

Airway problems: blood, blood clots, broken teeth, dentures, bone, food

C-Spine injuries: any force strong enough to produce facial injuries may have caused c-spine as well

Ventilation: can be difficult with extensive facial trauma. Paramedic intubate required?

Impaled Objects in the Cheek: as long as they remain it will be impossible to control profuse bleeding.

Question 4

management of:

Maxilla-Facial Injury

Answer 4

Airway - open mouth, do finger sweep to clear debris and feel for lacerations or deformities

Breathing - If spontaneous administer O2 to ensure brain perfusion

Circulation - control bleeding. both sides of full thickness cheek injury.

Pain Relief - might not be able to self administer Entonox

Question 5

Eye Injuries

Answer 5

Should be considered serious

2 main types:
Chemical contamination
Embedded object or an injury

Question 6

how to examine:

Eye Injuries

Answer 6

ALWAYS check for damage to:

The Orbits and Eyelids - ecchymosis, swelling, lacerations, tenderness

The Conjunctivae - Redness, pus, foreign bodies

Pupillary Reaction: size, shape, equality, reaction
Clarity of Vision: visual activity of each eye
Eye Movement: can it move in all directions? paralysis of gaze? dysconjugate gaze (failure of eyes to run together)?

Question 7

management of:

Eye Injuries

Answer 7

Place pt at rest

Check for contact lenses and if worn try to get pt to remove them

Constant reassurance for pt

?Associated maxilla-facial, head or C-Spine injury

consider removal to specialist eye unit

Cover both eyes to prevent pt moving injured eye with good one

Do not forget to tell the pt what is happening and why

Question 8

management of:

Chemical Eye Injury

Answer 8

Flush with copious amounts of clean water
Do not contaminate other eye
Do not apply direct pressure to eye itself
Cover both eyes with sterile dressing
Get sample of chemical, if safe to do so

Question 9

management of:

Embedded Object Eye Injury

Answer 9

Cover both eyes with sterile dressing
Use built-up dressings around the embedded object to prevent movement
Do not try to remove foreign body
Do not apply direct pressure to the eye itself
Encourage pt not to rub their eyes

Question 10

complications of:

Eye Injury

Answer 10

Lacerations and Contusions
Avulsed (detached) eyelid
Laceration of eyeball
Avulsion (detachment) of eye
Burns