Facial and chest trauma Flashcards
(44 cards)
Describe emergency airway management
- Chin lift
- Jaw thrust
- Oropharyngeal suctioning
- Manually move the tongue forward
What is the definition of LeFort I maxillary fractures?
Horizontal # of the maxilla at the level of the nasal fossa that allows motion of the maxilla while the nasal bridge remains stable
What are the clinical findings of LeFort I #?
- Facial oedema
- Malocclusion of the teeth
- Motion of the maxilla while the nasal bridge remains stable
What is the definition of LeFort II fractures?
Pyramidal # involving the maxilla, nasal bones, and medial aspect of the eye orbits
What are the clinical findings of LeFort II #?
- Marked facial oedema
- Nasal flattening
- Traumatic telecanthus
- Epistaxis or CSF rhinorrhoea
- Movement of the upper jaw and nose
- Likely periorbital bruising (usually suggests basal skull #)
What are LeFort III fractures?
through the maxilla, zygoma, nasal bones, ethmoid bones, and base of the skull
What are the clinical findings of LeFort III #?
- Dish faced deformity
- Epistaxis and CSF rhinorrhoea
- Motion of the maxilla, nasal bones, and zygoma
- Severe airway obstruction
What are the management points for maxillary fractures?
- Secure the # and airway
- Control bleeding
- Upper body elevation, 15 degrees
- Consult with maxillofacial surgeon
- Consider antibiotics
What are the clinical findings of mandible fractures?
- Mandibular pain
- Malocclusion of the teeth
- Separation of teeth with intraoral bleeding
- Inability to fully open mouth
- Preauricular pain with biting
What are the risk factors for mandibular dislocation?
- Weakness of the temporal mandibular ligament
- Over-stretched joint capsule
- Shallow articular eminence
- Neurologic diseases
What are the four ways the mandible can be dislocated?
Anterior, posterior, lateral, and superior.
Most mandibular dislocations are ____.
Bilateral
What is most likely to cause a posterior mandibular dislocation?
Direct blow to the chin
What is most likely to cause a lateral mandibular dislocation?
Associated with jaw #
What is most likely to cause a superior mandibular dislocation?
Blow to a partially open mouth
What are the clinical features of a mandibular fracture?
- Inability to close mouth
- Pain
- Facial swelling
What is hyphema, and what causes it?
Blood in the eye, usually caused by trauma and accompanied by an increase in intraocular pressure
What are the symptoms of hyphema?
- Visible blood in the front of the eye (may not be visible if hyphema is small)
- Sensitivity to light
- Pain
- Blurry/clouded/blocked vision
What is the definition of a pneumothorax?
A collection of gas in the chest or pleural space causing part or all of a lung to collapse.
What are causes of pneumothorax?
- Fractured rib punctures/lacerates the lung
- Paper bag effect (instinctual gasp before an impact)
- May occur spontaneously in tall, thin young males
- Asthma
What are the findings of pneumothorax?
- Tachypnoea
- Tachycardia
- Pleuritic pain (possibly referred to shoulder or arm on affected side)
- Decreased chest wall movement
- Decreased or absent breath sounds
Describe the management of pneuothorax
- Establish airway
- High concentration O2 with NRB (assist with BVM when decreased or rapid respirations or inadequate tidal volume)
- IV fluids
- Monitor for tensioning
What is an open pneumothorax?
An object penetrating the chest
What are the signs and symptoms of an open pneumothorax?
- Chest not rising normally during inhalation
- Pain increases in breathing
- Cyanosis
- Subcutaneous emphysema
- Tachycardia
- Penetration or breach of chest wall
- Sucking/bubbling from wound
- Casualty coughing up blood
- SOB/difficulty speaking
