FACIAL TRAUMA Flashcards
DDx
Intracranial Injury
Frontal Bone Fracture
Orbital Fracture
Globe Injury
Midfacial Fracture: LaFort I-III
Mandibular Fracture
Dental Injury
C-Spine injury
MANAGEMENT
IMAGING
CT Facial Bone without contrast
CTA to evalutate blunt cerebrovascular trauma in patients with LeFort II, LeFort III ir complex mandibular fracture
CONSULTATION
Fractures associated with airway compromise or hemorrhage
Orbital compartment syndrome
Globe Rupture
Oculocardiac reflex
DOCUMENTATION
HISTORY
Ask about:
Mechanism of injury
Timing of injury (of any laceration)
Use of protective gear
Visual change
Facial Numbness
Changes in dental occlusion
LOC
Headache
Nausea / Vomiting
Neck pain
PHYSICAL EXAM
Document:
GCS
Swelling, erythema, bruising, deformity
nasal mucosa (patency, hematoma)
rhinorrhea or otorrhea.
epiphora (overflow of tears onto the face).
Palpate facial structures for instability
Test the patient’s mobility on both sides of the face as well as in the midline because fractures can be found unilaterally.
Halo test: The separation of nasal fluid with a bloody center encircled by a “halo” of clear fluid suggests a CSF leak
ddx: saline, saliva, and other clear fluids.
Hemotympanum
Evaluate Malocclusion
Dental Exam
CN Exam
visual acuity
intercanthal distance.
slit lamp exam with fluorescein.
C-spine
