Maxillofacial Trauma Referral

Question 1

Pre- assessing trauma case

Answer 1

• ATLS principles
  Advanced trauma life support

A- airway
B- Breathing
C- circulation
D- disability

Question 2

Who might have mandible fracture?

Answer 2

• sublingual haematoma (Bleeding and swelling under the tongue)
• abnormal sensation contralateral to side of injury
• pain
• unexplained numbness by direct injury to nerve

** might need 2 Xrays

Question 3

Treatment of mandible fracture?

Answer 3

• fast
• analgesia
• AB for open fractures
• liquid diet
• immediate discussion with OMFS team

Question 4

Midface fracture including zygoma

Answer 4

• epitaxis without a blow to the nose
• V2 numbness without a direct blow to the nerve
• subconjunctival bleed
• midface mobility
• malocclusion
• surgical emphysema around eye
• diplopia

Question 5

Le fort fractures

Answer 5

Question 6

Treat zygoma fractures

Answer 6

• no routine AB
• call OMFS, followed up in 7-10 days
• no nose blowing
• soft diet
• may have retrobulbar bleed

Question 7

How to treat maxilla

Answer 7

• need to treat fast
• antibiotics
• discuss with OMFS
• liquid diet
• no nose blowing

Question 8

The referral route

Answer 8

• contact OMFS DCT via switchboard, page them
• have pt details ready; CHI, phone number
• keep pt fasted until discuss
• do not tell pt about their date of review, all are allocated by seniors and based on need
• not appropriate to send pt to QE without discussion