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Otolaryngology > Maxillofacial trauma > Flashcards

Flashcards in Maxillofacial trauma Deck (17):
1

What are the ABCs of trauma management

A - secure airway
B - make sure pt is breathing and ventilating well
C - ensure adequate circulation (stop bleeding and fluid replacement)

2

What is most common cause of airway obstruction in a patient with an altered level of consciousness? How can you treat this?

Tongue falling back into the throat
Jaw lift, oral airway, long nasal airway

3

what are 2 reasons why an endoracheal intubation through the mouth not work?

1. Pt has cervical spine injury
2. Landmarks are distorted due to trauma

4

If a pt has no C-spine fracture but all you can see is blood, how can you get an airway?

Cricothyrotomy

5

What is the procedure of choice If there is concern over a fractured larynx (widened thyroid cartilage, subcutaneous air [crepitus], neck bruising, hoarseness, coughing up blood)

Tracheotomy

6

When do you perform a fiberoptic nasotracheal intubation? Do you wait after inspiration or expiration to pplace the endoscope?

if you cannot do an oral intubation. This involves a tube through the nose into the hypopharynx.
l just after an expiration, because the ideal time to push the endoscope through is when the patient breaths in, opening the vocal cords

7

What is the advantage of a fiberoptic nasotracheal intubation?

Neck is not manipulated and you still dont know if spine fracture is possible.

8

Should the patient be awake during this procedure and what's the best position for a fiberoptic nasotracheal intubation?

Awake and sitting upright (tissue collapse may make the procedure harder if you are supine)

9

Which is not true?
A. You cannot perform an oral intubation (if the lateral C-spine film shows a broken neck)
B. You cannot perform a nasotracheal intubation (if the patient has profuse oral bleeding
C. indication for an emergent (“bedside”) surgical airway, is in a patient who is unable to be intubated and unable to be successfully ventilated with a mask
D. a patient w/severe laryngeal trauma should get an emergent "bedside" surgical airway

D. mask ventilation or intubation could worsen the syndrome

10

Anyone who has sustained enough trauma to break a facial bone should be assumed to have a ___ fracture until this is ruled out

C-spine

11

What are 3 rules of maxillofacial trauma management?

1. ABCs
2. Rule out C spine fracture
3. evaluate the pt completely

12

When does swelling for a nasal fracture typically go down? Can be reduced up to how many days?

5-7
14

13

If the nasal septum has been broken, you must rule out what?

septal hematoma—the formation of a blood clot between the perichondrium and cartilage that disrupts the nourishment of the cartilage --> septal necrosis

14

grasping the maxilla area just above the front teeth and applying a gentle rocking motion helps you evaluate what?

The stability of the maxilla
If unstable this is a LeFort fracture

15

A basal skull fracture or temporal bone fracture can leak ___ into the middle ear, which drains down into the eustachian tube and out the nose.

CSF. This is called CSF rhinorrhea

16

CSF mixed with blood produces a ring sign on the sheets or on filter paper, and also that CSF has a measurable ____ concentration, while mere nasal secretions do not.
Where is the leak?

Glucose.
Cribiform plate

17

What protein is only in CSF?

Beta2 transferrin.
Positive test = CSF leak