Facial Injuries Flashcards Preview

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Flashcards in Facial Injuries Deck (11)
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1
Q

Dental avulsion

  • Describe
  • Initial eval
A
  • Complete removal of tooth including root
  • Hx: how long has it been out, has it be preserved?
  • In ED: place tooth in saline or toothsaver
  • CT: ensure no facial fractures
2
Q

Dental avulsion

- tx

A
  • Nerve block
  • Irrigate the hole (remove clot and debris)
  • Push tooth back in (hard)
  • Coe-Pak: temporary bond
  • Can dry with O2
  • Ensure good dental f/u
3
Q

Facial fracture

- initial eval

A
  • Always suspect c-spine injury
  • Stat imaging: CT face/head, panorex (do not use XR)
  • Neuro and eye exam: double vision at extremes of visual field: suspect orbital fx, trismus: mandibular injury
  • Use LeForte fx to classify
4
Q

LeForte Fx

A

I: Palatal segment separated from upper midface

II: Pyramidal fragment containing upper teeth is separated from face through inferior orbital rims and nose

III: Separation of facial bone from cranial bones, fx line runs through zygomaticofrontal sutures, across floor of orbit and nasofrontal junction

(good picture in slides)

5
Q

Facial fracture

- Tx

A
  • Stabilize
  • Pain management
  • Fluids (hard to swallow)
6
Q

Orbital fracture

  • overview
  • s/sx
  • PE
A
  • Ophthalmic emergency
  • Can impinge eye muscles and nerves
  • S/sx: No full EOM, pain with EOM, double vision
  • Soft tissue swelling – hard to do PE. Use Pain meds bc must open to eval for globe injury
7
Q

Orbital fracture

- Tx if there is globe injury

A
  • ophthalmologist consult
  • abx
  • eye shield
8
Q

Mandible injury

  • types
  • S/sx
A
  • Dislocation, fracture, or both

Dislocation

  • Lateral blow more common to cause
  • Mouth stuck open

Fracture

  • Might present with little deformity!
  • Assess airway, assess if can handle secretions
  • Maxofacial surgery for plates or wires
9
Q

Lip lacerations

  • assessment
  • repair/tx
A
  • Assess for severity: through and through or vermillion border involvement.
  • Dt cosmetics, be careful (legal risk)
  • Align vermillion border with 1st suture (have pt or family look to see if it looks normal), if can’t align call plastics
  • Through and through:
    • Interior: gut or vicryl, do first, then exterior
    • Exterior: ethilon/prolene
    • Abx
10
Q

Nasal injuries

- general trauma

A
  • XR: hard to see dt overlapping bones
  • CT: may be overkill if no major deformity
  • Only need to reset if patency is lost
  • Refer to plastics
11
Q

Nasal injuries

- Septal hematoma

A
  • Can be d/t septal fx
  • Bilateral: risk for patency
  • Urgent ENT referral: I&D
  • IV abx to prevent infection which can lead to permanent deformity, osteo issues, intercranial abscess which can lead to meningitis