Facial Trauma
Summary: <br> There are 6 major areas/injuries to the face.<br> <br> <br> <br> Basic Approach to Facial Injury<br> <br> <br> <br> * Step 1: Airway* Indications for intubation after trauma* Burns to the airway* Rapidly expanding hematoma* GCS <8* Step 2: CT Maxillofacial Without Contrast* Step 3: Supportive Care* Stop bleeding* Apply pressure* Control epistaxis* Caution advised with packing if patient has basilar skull fracture* Ice* Analgesics* Step 4: Antibiotics* Common indications* Fractures of a sinus* Open fractures* Step 5: Consider Consulting the Appropriate Specialist* Eye trauma -> Ophthalmology* ENT trauma -> ENT* Oral/Dental trauma -> Oral/maxillofacial surgery or dentistry<br> <br> <br> <br> Six Key Facial Injuries<br> <br> <br> <br> * Frontal bone* Fractures of the INTERNAL frontal sinus wall = BAD* Eyes and orbits* “Blowout” fractures with entrapment of the extra-occular muscles = BAD* Nose* Septal hematoma = BAD* Zygoma (Cheekbone)* Zygomaticomaxillary complex fracture (aka Tripod fracture) = BAD* Maxilla (Upper jaw)* Le Fort fractures = BAD* Mandible (Lower jaw)* Open fractures (intraoral laceration) = BAD<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Trauma Basics <a href="http://www.emclerkship.com/trauma/">(EM Clerkship)</a>* CORE EM: Facial Fractures <a href="http://www.emdocs.net/core-em-facial-fractures/">(emDOCs)</a><br>
