Facial, eye, dental injuries Flashcards
A player with a suspected mandibular fracture could present with which two of the following signs and symptoms?
- Sublingual haematoma
- Bleeding in the external auditory canal
Epistaxis originating from the Kiesselbach’s area (a vascular network of the four arteries that supply the nasal septum) is usually controlled by pinching the nose for up to 10 minutes.
True or false?
True
Epistaxis is one of the most commonly encountered nasal injuries in football.
True or false?
True
Posterior epistaxis may need positioning and packing if local pressure fails to arrest the bleeding.
True or false?
True
Nasal fractures make up approximately 50% of all sports-related facial fractures and are defined by the following signs and symptoms: deformity, epistaxis, swelling, impaired breathing via nostrils and the potential for septal hematomas.
True or false?
True
Septal haematomas form from nasal contusions and if left unidentified or untreated may cause cartilage damage. They should be drained, if necessary, to avoid this outcome.
True or false?
True
The following statements reference facial fractures in general.
Which one is incorrect?
Common symptoms of nasal fractures include epistaxis, crepitus, septal deviation, septal haematoma and dorsal tenderness
If the player cannot breathe due to septal dislocation, inserting a gloved little finger into the affected nostril and flicking the septum back into place can relocate it
A player with a septal haematoma should be referred urgently to ENT for drainage to prevent subsequent erosion of the septum
Mid-face fractures involving the maxillary bone and surrounding structures are described using the Le-Fort classification
Injury to the maxillary region may result in bony instability and airway compromise
Common signs/symptoms of a mid-face fracture include elongation of the facial skeleton, malocclusion, bilateral subconjunctival haemorrhage, bilateral periorbital ecchymosis, CSF rhinorrhoea, and altered sensation of the lateral nasal and infraorbital skin as well as the maxillary teeth
If the airway is compromised with a mid-face fracture and the player is unable to maintain their own airway, it may be initially necessary to use a gloved hand to draw any unstable segment forward to open up the airway
Mandibular condyle dislocation is usually bilateral and typically results from a blow to the mandible. In the presence of crepitus, relocation can be attempted
Mandibular relocation is achieved by placing the thumbs inside the player’s mouth on the molars with the fingers wrapped externally around the mandibles. Firm, slow, and steady downward pressure is applied in an infero-posterior direction
Zygomatic fracture typically occurs as a result of a direct blow to the lateral side of the face
In the event a facial/dental injury involves a blunt trauma MOI to the head, it is best practice to apply MILS until a significant head injury and/or cervical spine injury is excluded. Concussion should also be considered in these circumstances.
Is this correct or incorrect?
Correct
The following statements all reference eye injuries, in particular orbital fractures, that may occur in football.
Which one is incorrect?
Fractures of the inferior orbital rim are the most common fractures
The orbital walls are thin and so susceptible to fracture
A blow-out fracture is considered to be a protective mechanism to prevent a rupture of the globe
Limitation of an upward gaze is suggestive of tethering of the inferior rectus muscle
Numbness of the face beneath the eyes may indicate infraorbital nerve injury
A blow-out fracture is a fracture occurring to the orbital floor resulting from a direct blow to the eye
Numbness of the upper gums may indicate infraorbital nerve injury
Signs and symptoms of an orbital fracture often become apparent when a player blows their nose
Some common signs and symptoms (not inclusive) of an orbital fracture include diplopia, orbital ecchymosis, enophthalmus, surgical emphysema and epistaxis
You are covering a football event and are called onto the field of play for a player who has suffered a fracture to his jaw. Your colleague applies c-spine control, but you are unable to assess the amount of damage. The player is struggling to breathe due to the copious amounts of blood appearing to come directly from his mouth.
What is your next immediate action?
Use a hand held portable suction device
During a tackle, a player is accidently poked in the eye. Initial examination on the field of play reveals a hyphema.
What is your next course of action?
Remove player immediately and range immediate transfer to hospital for specialist treatment
What is a hyphema?
Blood collecting in the frint chamber of the eye
One of your players suffers an injury to his jaw from an illegal high tackle. He is stable following your A-E approach and assessed to be P on the AVPU scale. From your assessment of his airway, you suspect either a fractured jaw or a mid-third face fracture. Oxygen is applied at 15 L/min, and his vital signs are stabilising. As you commence collar application to prepare to extricate him from the field of play, he develops a stridor noise and his respiratory rate rises. When the collar is removed for reassessment, the stridor stops.
What is your next immediate action?
The collar is aggravating his underlying injury. Therefore, continue with manual inline stabilisation (plus head blocks and straps for extrication).
What associated injury could co-exist with the jaw injury to cause the symptoms of stidor when fitting a collar to a injured player?
Fracture of the larynx
Common symptoms of nasal fractures
epistaxis, crepitus, septal deviation, septal haematoma and dorsal tenderness
